To imagine that some little thing - food, sex, power, fame - will make you happy is to deceive yourself. Only something as vast and deep as your real self can make you truly and lastingly happy.

--Nisargadatta (1897-1981)

One instant is eternity; When you see through this one instant, You see through the one who sees.

-- Wu-men (1183-1260)

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To the many people who have sent questions and still are waiting to hear from me, my apologies. When I began this website in 2004, my intention was to offer advice to those who otherwise might not have access to the ideas of an experienced psychotherapist. Happily, the site has been successful. In these past years I have received many thousands of questions from all over the planet, and have replied to hundreds of them--some here on the site, and many others privately.

Unfortunately, the very success of this website means that more and more questions must go unaddressed. My inbox is simply jammed with letters to "Dr. Robert"--so jammed in fact that I cannot even read all of them fully, much less reply. Even if I did not have my therapy practice here in Todos Santos, as well as other other responsibilities, there still would not be time to deal fully with this volume of mail. Evidently a significant number of people from all over the world want and need psychological advice and are finding it here. But I can do only what time allows, and so I will never be able to address the needs of everyone who visits this site. For that I am sorry.

In order to deal fairly with the increasing volume of mail, I have had to change the protocol for submitting questions for "ask dr. robert." As a first step, please post your question on the Dr. Robert Forum where it may open a discussion among forum regulars--many of whom bring intelligence, experience, and wisdom to these conversations. I check in on the forum regularly, and will contribute if and when necessary. As of January 5, 2011, the Forum now includes a real-time chatroom.



Rcently, I published a memoir called Awakening Never Ends which speaks about my work as a psychotherapist and spiritual teacher, about awakening with the help of my teacher, Walter Chappell, and about what the experience of "enlightenment" or non-duality is not. If you are interested in this kind of thing, I invite you to give it a look.





Recent Threads Of Interest On the "Dr. Robert Forum:"



  • Thank You, Doctor Robert.

  • Is my therapy supervisor out of line?

  • Is Buddhism/spirituality and things involving the ego or lack of ego healthy?

  • Moral Camouflage or Moral Monkeys?

  • Another sibling exploitation story. How to cope with the guilt?

  • Is it possible to be a heartless Buddha?

  • Belief: What Is It, and From Where Does It Come?

  • Confessions about love, relationships guilt and the world from a young sociopath.











  • Dear Dr. Saltzman,


    Thank you for you work and this site.


    I am a 38 yr old single female, who has had four long term, four year and a few shorter 1-2 year relationships with (generally speaking) decent, professional men – 11 years ago I met a young man (25), when I was 27, we had a very on again off again relationship that was extremely painful and unusual for me. The three, four-year relationships prior to this man were calm, committed and loving.


    Admittedly, I was naïve when I met this man and very much used to the 'normal' bounds of relationships. I had not been promiscuous when younger and did not know what a 'player' was, I figured that most men were decent and where in a relationship with me because they wanted to be with me specifically. It never occurred me, prior to meeting this man, that some people are in relationships because they can't be by themselves. Despite having several relationships myself, I tend to enjoy being alone and in relationships and have had several single years between partners.


    The man, who I will call 'B', was highly promiscuous when younger (as he told it at the time), suggesting to me that it was 'out of his system'. He was VERY interested in me and spent as much time around me as possible in the fist three months or so. To cut a long story short – his continual setting up of other women on the side and sleeping with them, orchestrating break-ups to sleep with them and then reeling me back in (all of which I did not KNOW at the time) almost sent me over the edge. My instincts/feelings were being triggered incessantly over the four years we were together, without knowing what it was that I was dealing with. I would attempt discussion, questioned him and was concerned that the relationship never seemed to progress, or deepen – he would fob it off as 'not used to being in a relationship' and suggest that I was possessive, and jealous etc (even thought I had never been before). I began to believe it because he was so much better looking, fun, outgoing and interesting than my previous partners that I figured that perhaps I was like that with him because I was so much more interested in him. I ended up stuffing my perceptions and feelings down (they became embarrassing) and feeling guilty and thankful that he had so much patience with me – FOOL!!! – A few years later, he entered recovery for sex addiction!!






    ask dr-robert




    My issue is that I have never been the same since –understandably – Disturbing, is something that happened toward the end of the relationship when the pain was so intense – I had began to sexualise the pain. I imagined him with various other women, some of whom were friends of mine, and despite the excruciating pain of it in reality, I became more and more aroused when fantasising about these betrayals - totally bizarre!!!


    Since that relationship ended 7 years ago, despite being in relationships with very nice men prior and wanting to go out with 'nice men' now, being professional, educated, knowing what I want and am looking for and being in recovery from co-dependency; I continue to attract abusive, dependent men. The last relationship ended in a broken nose and two black eyes after three months with a very charming, highly intelligent, and articulate man who turned out to be an ex-cocaine addict, gangster!!! – Unbelievably – I am so gullible and accepting of different personality types and preferences - its scary!


    I ask questions, I can say 'No!', I am assertive, I confront unacceptable behaviour rationally and calmly etc. – It's like I'm a magnet for abusive men since the relationship with 'B' – I am just not the same – I accept that it happened, I understand it, the disease, my role etc – it's the legacies that remain that are the problem. While I have sought specialist treatment, no one has been able to help with the sexualisation of abuse and how to address it – which to me – appears to be a significant problem.


    What is scary is an apparent progression, I may have sexualised the pain of betrayal with 'B', but now I have become extremely aroused by the raw potential of violence in this other man. I don't want the violence but there is something arousing about the embodiment of its potential in this man. Although I did not continue seeing him after he kicked and hit me, I do continue to fantasise about him sexually (not about the actual abuse itself but the raw energy of his potential for violence) and am frightened by the possibility that I could return to satisfy what appears to be anger disguised as sexual passion. It is as if I have twisted his/the/their objectification, disregard, betrayal to cope with my pain and anger into something manageable: desire – from repulsion (which I am aware 'should' be my response) – to desire. It is perverse to me but I do not really know how to change it and believe that I will continue to attract men like this until I correct my emotional ledger. Initially I felt compassion for him, believing that no one really wants to do those things (your site suggests otherwise), then intense fear, which has now become arousal – I did not and have not experienced horror or repulsion even though I did with 'B'.






    ask dr-robert




    I don't know if I have been seeking the wrong psychological help, if this is fairly common, if it may be underpinning what appears to be something in me that abusers are attracted to since 'B', or what to do about it and hope that you can help. The potential that I have some sort of Stockholm Syndrome has not escaped me.


    I do not sexualise abuse itself and certainly do not go around thinking that I am aroused by it, but it is common to my partners when they abuse me; it forms some kind of sick bond, like a perverse type of intimacy. I have thought my response could be a form of self-righteousness, hatred or martyrdom, except that it does not seem to have anything to do with my 'normal' thinking – like it's sort of split-off somehow and does not match any of my other behaviour, anything else I think, believe or stand for.


    I seek a stable, safe, sharing, caring relationship with an emotionally mature, generous and kind man – not an abuser - and would like to address whatever it is in me that sexualises abuse – I was not abused as a child.


    Thank you for taking the time to answer my concerns. Your suggestions and comments would be much appreciated


    Sincerely,


    Female38


    [Thank you for not publishing my contact details or name if you choose to post to your site]








    ask dr-robert






    Dear Female--

    Yours is an interesting and well written letter which raises many questions that should be addressed in a therapeutic setting. However, here on my website such a dialog is not possible, so, although there is much I would like to ask, I will do what I can, working just from the information in your letter, to shed some light on your situation. This will be the final "ask dr-robert" of the year 2009, and I ask the pardon of those who have written and are still waiting for a reply. I am doing my best to keep up with the huge volume of mail I receive, but answering everyone is simply impossible.

    Now you say that you "seek a stable, safe, sharing, caring relationship with an emotionally mature, generous and kind man – not an abuser. . . ." But that is simply the rational mind, or ego speaking. And the ego is not the totality of ones being—far from it. Clearly, there are parts of your being which find what you call "decent men" less sexually intriguing than "bad boys" who like to use and abuse their lovers. You have put this in a rather passive way, saying that you "continue to attract abusive, dependent men," but that finesses the plain fact that it is not just that those men are attracted to you, but that you are attracted to, and become involved with, them. Many women do.

    You attempt as well to shift the "blame" for your interest in bad boys, which obviously you find embarrassing and disconcerting, by assuming that your contact with the first of them somehow altered your original emotional character so that now you find violence and abuse sexually stimulating, whereas before meeting him your sexual desires never would have moved in that direction. I cannot easily agree with that idea (although, to be fair, if you were in therapy with me I would now be asking questions aimed either at substantiating my doubts or discrediting them). I find myself thinking it much more likely that your failure ever to stay very long with a previous lover (the "decent" ones) indicates that something in you is bored, sexually, by such men, and that your excitement with what you call "the raw energy of his potential for violence," has nothing to do with having been "turned out," by the first bad boy, but is simply a part of your life-long emotional makeup.

    Working from that idea—which I believe very likely expresses something true about your situation—would provide, in my view, a much better platform for therapy than your current view that somehow your sexuality was "perverted" by your experiences with the first bad boy. And, as an explanation, Stockholm Syndrome isn't even in the running.

    This is an extremely complex matter which demands highly skilled psychotherapy, and I wish you luck in finding it.

    Be well.





    ask dr-robert








    Dear Dr. Robert--

    I have been suffering terribly because my daughter has gotten into trouble with drugs and men, and I am afraid that she will never have a decent life. As you know from my last letters, I have been a Christian all my life, and have tried to pass the teachings of Jesus on to my daughter, but she does not believe. A few years ago I discovered gangaji, and since then I have attended her satsangs whenever possible. I have been fortunate enough to have several private meetings with gangaji, and she has told me to stop worrying about my daughter. She told me that I am very close to enlightenment, and that when I attain it everything will seem different. I will no longer suffer, and will experience happiness without an end. gangaji says that if I keep trying I will attain in this very lifetime, and will not have to take anymore rebirths. Until then, she told me to take refuge in my faith, and in her, my guru. You seem to be an enlightened person. Please tell me what I should do to speed up this process of attaining enlightenment, as I am weary of suffering.

    Carlotta,Tucson, Arizona






    ask dr-robert




    Dear Carlotta--


    Well, I need to say before I begin that you may not like what I have to say about "enlightenment," gurus, and all that stuff, but since you have been reading my website, you already know that I have made it a practice not to mince words when replying to important questions. In other words, I simply speak or write from my own experience for whatever it is worth, without considering that someone listening or reading might be offended by my words. This is the only way, because if I once started considering whether someone's beliefs might be threatened by my words, and so ended up soft-pedaling my reply to the questions I receive--"respecting someone's faith," as this is often unfortunately put--then I would be left with nothing to say at all about these matters.

    I am trying to make this clear at the outset because you have said things in your earlier letters to which seem to indicate a set of beliefs, a kind of faith, which, in my view, is not helpful to really understanding anything. Quite the opposite in fact: faith of any kind at all is totally counterproductive to understanding. "Faith" after all is just another word--a better sounding one--for "credulity," which means believing something simply because someone in authority, or who claims authority (Gangaji, in your case for example), has said it. But why should Gangaji be an authority on something that has occurred, or not occurred, in your experience? What makes her an authority on your experience? And if you believe Gangaji, then it is you who has found Gangaji worthy of credence, which has nothing to do with Gangaji, but only to do with your own discernment, understanding, and awareness. After all, Carlotta, there are people who see Jerry Falwell as an authority on spiritual experience. They honestly imagine that Falwell can tell them what "God" wants and what they must do next in order to be "saved." Absurd, isn't it? But why is trusting Gangaji, who for all you know might be hypnotized, deluded, or just mistaken, any different? I do not know anything about Gangaji except that she is a well-known teacher, so this is not a judgement of her, but rather a comment on your process.

    That said, I dislike the word "enlightenment," and wouldn't use it myself at all except to reply to your kind of question. The problem with that word is this, Carlotta: it refers to something entirely unimaginable, but about which many people imagine they already know something. Rather than simply accepting that a state of awareness which they are not experiencing (if they were experiencing it, they certainly would not be asking about or wondering about it) is literally unimaginable, people are tempted to use their imagination anyway, and so they conjure up visions of a special state, totally different from "ordinary life," with all of its fear, pain, and suffering. When finally I am "enlightened," this fantasy goes, I will be as I am now, except that I will understand everything, and I will be happy. This is really no different at all from the Christian myth of heaven, which may help to explain why so many humans get caught up so childishly (the guru is like mommy or daddy) in seeking "enlightenment." What is being sought is not awareness or understanding at all, but just an end to suffering such as the religious indoctrination of their childhood promised would reward true believers (while the others burned in hell, of course). How foolish. How dreary.

    To put this another way, I do not like the way I feel now, so I imagine a state sometime in the future when I have "attained enlightenment." When that happens, the fantasy goes, I will be special. I will be different from everyone else (except the other enlightened people). I will not suffer as others do, and as I do now. I will know the answers to all of my questions. I will know "God," or know if there really is a God or not. Perhaps I will have magical powers. I will be able to manifest whatever I choose. But that is all just a fantasy, a fantasy of future happiness, future power, all that I will have attained when finally I am enlightened. And the future never comes. When tomorrow comes, it comes as the present, not as the future, and it comes not as a fantasy, but as the facts and feelings of this very moment. So fantasies of enlightenment and salvation are a denial of the present, which is an eternal present. Fantasies of enlightenment are nothing more than a denial of this very moment which is the only moment there is or ever was. In other words, as long as someone is thinking about "enlightenment," or any other version of salvation for that matter, that person is in denial of actual being. That person lives in a kind of trance state which seems to be about something "spiritual," but which is really no more than the self-hypnosis of a mind which, being  fearful, has become addicted to escapism.

    Each of us is caught up emotionally in a very complicated drama called "life." In that drama, "I" am the main character, and other people have supporting roles of greater or lesser importance. Everything I do, everything I say, everything I worry about, everything I desire, everything I avoid, everything I seek (including "enlightenment") only serves to support the existence of that character, to flesh him (or her) out, to solidify his existence, to define him. "I" have a life story which provides the background for that character, and I have relationships which both support but also trouble the character in that drama. And that "I" has a body which can become ill and die. "I" knows this is true because "I" has seen others become ill and die. But the idea that my character, my "I,"--my ego, to use another term--which has struggled for so long just to define itself and to survive, will die (cease to exist at all, that is) is intolerable to me, so I invent an afterlife, or many afterlives one after another. I engage in discussions with others about God, Buddha, karma, enlightenment, etc. And it's all bullshit. It's all fantasy. It's all a claim to know something about the unknowable. It's avoidance. It's denial. It's wishful thinking. And, there is no shortage of people ready, willing, and able to make a profit on that. To sell tickets, to sponsor events, to sell books, be supported by disciples, etc. ad nauseam.

    Such people often claim to be "enlightened," but you can be quite certain that anyone who claims such a thing is either a shameless liar, or totally self-deluded. The very idea of a separate person with a past and a future--a "someone" who could become enlightened --is already a misconception, a kind of contraction or dumbing down.
    When I say "contraction" I mean this in the sense in which a hand can be contracted into a fist. The hand is still there, but cannot be seen until the fist is relaxed, then the fist disappears, and the hand appears again "by itself." It was always there, but its contraction into a fist prevented experience of the hand, as a hand. The same is true of awareness. It is always there, and does not belong to any one person in particular. When the contraction called "myself" or "my ego" relaxes sufficiently then awareness experiences itself for what is is. No one can do this or "attain" this. It just happens. It cannot be done or attained because the very idea of someone doing something just strengthens the contraction all the more. That's what the contraction is, after all, the idea of a separate person who does things, makes choices, has a guru, becomes enlightened. I call it a contraction because it is a squashing down of the universal, always existing awareness into the tiny prison of an individual ego, so that what was open-eyed, nonjudgmental, clear-headed awareness (and still is, but unnoticed, not experienced) now is called "my awareness, my enlightenment, my attainment, my point of view, which is the clenched fist, not the open hand. If you get the flavor of this, then you will understand that no one who claims enlightenment, or claims being able to decide who is on the verge of enlightenment or not, knows the first thing about any of this.

    When this total inability of the personality to attain "enlightenment" by any means, any practice, any belief, any "purification," anything whatsoever, is seen, the drama of becoming ends. What is, simply is, and cannot become anything. The bullshit stops. Each moment is fresh, different from any other, and entirely unspeakable. The future never arrives. "Enlightenment" isn't even an issue or anything to think about. One simply experiences what humans experience from moment to moment, and that's it. And that is sufficient.

    Before signing off, Carlotta, I just want to say that I understand your suffering--you have been through a lot by now--but that I want to encourage you to stop trying to find refuge. Just allow yourself to be, and stop trying to get answers to questions which cannot be answered. Stop trying to find refuge in ideas. Stop trying to find refuge in Gangaji and her opinion of you. Stop looking for refuge in Jesus, in enlightenment, in judging whether your past experiences were special experiences which indicated "enlightenment" or just some of the varied and sometimes intense experiences of the ordinary human mind. Stop believing in things and just be. Stop looking for refuge in in anything. When all of that seeking stops, then see where you are.

    Be well.












    Dear Dr. Robert,

    My husband’s ex-wife has borderline personality disorder. She has been engaging him in a legal battle since she found out we were engaged – they have a teenage daughter together.

    Her last legal battle did not go the way she had hoped and now she has been making threatening statements that include thoughts and fantasies of their daughter’s death.

    My husband and I are in a panic and quite unsure as to how to proceed. Do we push to gain sole custody and perhaps a court ordered evaluation of the mother? Or do we treat this as another inflammatory statement and example of outrageous displays of anger and not react.

    How often do people with BPD actually harm others? The woman has no history of violence, but recent events–loss of employment, her daughter becoming a teenager, her ex-husband’s remarriage and a failed attempt to exact revenge through the courts have us worried that she may “have nothing to lose” so to speak. We know that she is blinded by her anger and sense of victimization – could this cause her to harm her child to hurt her ex-husband (like she has fantasized in emails about doing)?

    Thank you very much,

    Christine


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    Hello, Christine--

    I understand your concerns. In order adequately to reply to them, I should first fill in a bit of background.

    The term "borderline personality disorder" arose originally to indicate someone who was on the borderline between neurosis and psychosis. The term "neurosis' is no longer used, but previously, someone who showed symptoms of depression, hypochondria, anxiety, obsession, or the like would be considered "neurotic," while someone who had lost touch with reality entirely (meaning shared, consensual reality) would be considered "psychotic." In this usage, the so-called "borderline personality" would be the most serious kind of neurotic illness—not so out of touch to be considered frankly psychotic, but disturbed enough so that, unlike most types of neurosis, treatment by means of psychotherapy was thought to be difficult or impossible.

    Borderline personality disorder is difficult to treat because psychotherapy depends on the establishment of a working relationship between the psychotherapist and the patient, but the very nature of borderline personality makes ordinary relationships uncomfortable, problematic, and fraught. In fact, although BPD is not at all uncommon—according to the National Institute of Mental Health approximately two percent of adults, most frequently young women, suffer from it—many psychotherapists entirely refuse to treat borderline personality, and many others who do take on patients with borderline symptoms find themselves out of their depth and so fail to help those people.

    Essentially, borderline personality disorder is a kind of mental illness characterized by pervasive instability in self-image, in moods, in interpersonal relationships, and in behavior. To take an example of this instability in relationships, a PBD type of person might at one moment regard a friend or loved one with great admiration, affection, and love, and then suddenly, without warning, switch over to an attitude of irrational disappointment, vehement anger, or even hatred. When this switch occurs, the BPD person will accuse the friend or loved one (or the therapist) of having abandoned, mistreated, or misunderstood her, or otherwise blame the other person for having caused the sudden breakdown in idealization and affection. Often, the BPD person interprets ordinary everyday events as intentional rejections. For example, if the therapist, due to a traffic jam or household emergency, arrived late for a session, the BPD person would not believe those reasons, and would accuse the therapist of caring more for other patients, or having lost interest in her. Regardless of any apology, the BPD person would feel rejected and abandoned, and would express those feelings through anger, depressed mood, threats ("I'll get even with you"), or even—and this is the core of your question—with violence.

    Although there are various theories, including theories of genetic predisposition, about the causes of borderline personality, in my estimation the best of those regards BPD as the outcome of narcissistic wounds sustained in early childhood. Such wounds could occur in any of numerous ways—too many to list, really, so I will choose just one illustration to give the flavor of it. Suppose, for example, that a baby began nursing, but then the mother became ill or depressed and could no longer manage the feeding schedule. In the infantile mind, the loss of the breast might feel like a rejection, and the baby might also feel that this rejection was due to a lack of self-worth. In other words, mom has stopped loving me because I am a bad child. Once that pattern of thought has become established, other random events might also be seen as adding proof to it. Later, for instance, if a sibling receives a gift that seems better than the one that our child receives, the child might feel that this is due to her lack of value.

    Now, each person's sense of self and self-worth is built up (or not built up) as the result of many thousands of such individual instances. A child who receives sufficient emotional support usually will become an adult with a strong sense of self-worth, but a child who lacks that kind of support may become an adult with a sense of self that is full of "holes" like a Swiss cheese. In other words, that adult, having a core self which is not solid but filled with gaps and "holes," will look not within but to others—to relationships—to fill those gaps. That is why such a person is so super-sensitive to any aroma of rejection, for the "rejection" is seen not just as unfriendly or unkind, but will be perceived as a threat to the very integrity of the self which might, if not supported properly, disintegrate entirely into a kind of "insanity." And this is a very sticky situation, because that kind of adult is looking, constantly and hypervigilantly, for the kind of support that he or she lacked as a child. In other words, that kind of adult wants, in a way, to be treated like a child: never disappointed, always cared for, always protected from the cruelties and realities of ordinary life. And such a person demands that kind of treatment from other adults. But, although some of the other adults might be able to offer that kind of support to an actual child, few would be able or want to offer it to another adult. Hence, this wounded ego, which wants an extraordinary level of support and consideration--an impossible level really--by its very demand that such treatment be provided, is setting itself up for rejection. Then, when the inevitable rejection comes, the ego, the "self" begins to come apart, to disintegrate, and the anger, mood swings, and all the rest follow.

    All of us experience changes, losses, and rejections in life, but if we have a more or less firm sense of self, we are able to roll with those punches, and keep going. The borderline personality type often cannot roll with any punches, and so, instead of moving on, may be come fixated on a "rejection," and then blame the person who did the "rejecting." As you are experiencing, this blaming often damages personal relations drastically, making it impossible for anyone save the most determined friend or therapist to continue interacting with the borderline person.

    With that background, let me address your specific worry. Borderline personality types sometimes do become violent when their anger at perceived rejections finds expression on a physical level. If that happens, usually the cause is not "nothing left to lose," as you wrote, but rather an extreme emotion of hatred or fury directed towards the person seen as having rejected or otherwise failed the borderline person. I imagine that your husband's having married you was perceived by his ex as a rejection of her (although of course it was not), and she may be feeling an inner rage that could spill over into violence, even violence directed at her own child whom she might view as an extension of her husband. Of course, none of this makes any sense, but that is the problem with borderline personality disorder. It is not rational.

    Since you have asked for my specific advice, here it is: I believe that you should take these threats seriously. They may be simply histrionic, but possibly not. In my opinion, your idea of suing for sole custody along with a court ordered evaluation of the mother may be the best course. If you do proceed in that direction, there is the risk that you will further anger this already very unstable person, but it seems to me that for the protection of your husband's child you do need to have more control over this situation, and sole custody could provide that. I am sorry not to be able to be more definite, but that is one of the problems with borderline personality types—their behavior is very hard to predict.

    Be well.








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    Dear Dr. Saltzman,

    My son has been dating a girl for the last five years. She is a different religion and there is a great difference in their culture (she is Hispanic and he is Jewish). She has broken up with him several times and even broken off their engagement once. She is always threatening to break up with him and although they are engaged again, she is always complaining that she is not happy. He just finished his radiology residency in Minnesota where they met and she said she would not move with him unless she was either engaged or married. They got engaged and she decided not to move anyway. He went to Michigan for a fellowship but she stayed back with family. He is miserable but makes excuses for her as to why she is not supportive of his situation. She is constantly complaining that she is lonely and unhappy and doesn't know how much longer she can take it. He is always feeling guilty and I think he even contemplated giving up his fellowship for her to remain in Minnesota. I am totally disgusted with her attitude. She is always threatening to go to Argentina and she decided to go there this November for three weeks supposedly to visit family. I can't believe that she wouldn't want to spend any vacation time with my son.

    My problem is this; How do I sanction this marriage? I dread going to the wedding. I don't think I can stand to see him walking down the isle. I know he will be making a very significant salary and I feel that is what is keeping her interested. I also feel that this is what is attracting her family as well. How do I get my son to realize that he is making a big mistake. Our relationship is already strained to the point where we basically can't talk about anything. He has been hurt so many times before but he won't give her up. To add to the problem, his twin brother just got engaged and will be having a wonderful wedding and all the things that my other son would want. At this point, her family is looking to my son to put together a wedding and pay for everything in her town and although I am an event planner in California, she refuses to do it here so I can help. I need an objective point of view. I would greatly appreciate any advise.

    Thanking you in advance.

    Barbara Needleman



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    Dear Barbara Neiderman--

    You are welcome.

    Assuming that your account of this relationship is accurate, your son is about to make a big mistake, and I think you should pull out all the stops in trying to convince him that no matter how much he desires this woman, he should avoid marriage until she demonstrates more commitment to his path in life. Since your relationship is strained to the breaking point anyway, it seems to me that you have little to lose by simply speaking from the heart--a mother's heart--and letting the chips fall where they may.

    Nevertheless, in my experience, it is very unlikely that you will be able to sway him from his intended course. Indeed, depending on his level of maturity, further expressing your opposition could even strengthen his resolve to go forward with his plans. However, as I said, since he already is determined to marry her, there seems to be very little to lose, and much, from your point of view, to gain by making one last argument.

    Then, if he does decide to go through with the wedding, I advise you to drop your opposition entirely, to wish him well, and to attend the ceremony in the most supportive, generous, and open spirit you can conjure up. After all, at that point what is the alternative? And, although you seem quite certain about your opinion of this girl, you could be wrong. Perhaps they will be happy together regardless of what you now imagine.

    As a father (and grandfather) myself, I know very well the pain of watching a child pursuing a course that seems unfortunate, self-destructive, or worse. However, that kind of pain goes with the job description: "parent," and everyone who even cares enough about his or her children to be concerned about their welfare and happiness must learn to live with it. However young and inexperienced he may seem to you, your son is not a child, and you must now allow him to make his own way in life, which includes making his own mistakes (if this relationship really is a mistake).

    To sum up: my advice is to take one more shot at convincing him to postpone the marriage, and if that fails, to accept as gracefully as possible his decision.

    Be well.






    Hello Dr. Robert,

    I wanted to ask you for your opinion on what you think should be a curfew for an 18-year old girl.

    I just started my second year of college and i consider myself to be extremely hardworking and studious. I have been able to maintain a 3.5 GPA and have no intention in becoming someone who goes clubbing every weekends, or goes out to get drunk with friends or do drugs or becoming sexually active. My parents have raised me well and i think that i have showed them what a responsible and trustworthy person i am.

    Since i started college, a lot of my friends have been wanting me to attend birthday parties, dinners, or just a regular day out with a couple of friends, starting at around 7 o'clock at night. I can assure you that i do not hang out with "the wrong crowd" and the friends that i hang out with my parents already know about. My parents have absolutely nothing against my friends but they do not let me come home late at all. Right now i am taking a biology class that is from 5:30-6:50, and my parents did not like the idea of me getting home at around 8:30p.m. Literally, my parents expect me to be home before sunset; they want me to be home at a time when there is still light outside, which is about 7:00p.m. So this is where the problem comes in.

    When i was in high school and my friends asked me to attend birthday parties that were around 8pm. i was not able to go because my parents said that was too late. So i respected their decision and told my friends i was not able to go. When i went shopping with my friends, my parents wanted me home before 8pm and i always came home before that time. Even whenever i am out with my friends, i always let my parents know that i have arrived to wherever it was that i was going, what time i should be expected to get home and who i was going with. I can assure you that i have never lied to my parents before. Wherever i said i was going, that is exactly where i went. But now that i am in my second year of college and for my curfew to still be at 8pm seems to be extremely unfair to me. I work so hard in school to make sure that i do not disappoint my parents and to also make sure that i graduate and be successful in achieving my goal of getting into dental school. I think i deserve to be given the chance of going out with my friends. There have been occasions where i have told my parents that my friends want to go out for dinner @ 8p.m. and my father told me that the only way he would give me permission is if we eat at an earlier time; so my friends were extremely nice enough to set dinner at around 6p.m. so that i can be home at 8p.m. But this is not always the case and it shouldn't have to be. I can't always make my friends change the time of having dinner in order to accommodate my needs. What about the rest of them? My dad always tells me that the reason he does not let me stay out past 8o'clock is because he loves me and does not want anything to happen to me.

    I love my parents so much as well and i understand that they care about me and i appreciate that so much but there are just times where i really want to hang out with my friends and have fun. I am so sick of having my entire life be concentrated on school work. That is basically what my entire life revolves around; school. I know what is expected of me and i am not going to allow myself to start slacking off and end up with a 2.0 GPA. There is absolutely no way that i am going to allow so many years of hard work go to waste. My parents always taught me that schoolwork comes first and i completely agree. But don't i deserve a little bit of excitement in my life? I made it clear to my parents that i am not going to become one of those "girls gone wild" type of people, but they always end up saying that they love me and they don't want to see me out with friends so late (Anything after 8o'clock is late for them). Do you have any suggestions for me, please let me know. Thank you !

    Carlotta



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    Hello, Carlotta--

    You are most welcome.

    Judging from your words, you are a decent and conscientious girl who both loves and respects your parents, and who does not wish to cause them any pain. However, their demands, as you have put them forth, seem to me to be excessive and way out of proportion to the possible dangers involved. Based on the attitudes expressed in your letter, if you were my daughter I would allow you to make your own decisions about where to go and when. In other words, I do not believe that you should have any curfew at all. But every parent is different, and it is important, it seems to me, that you continue to try to respect yours even though their ideas about what is good for you do not seem relevant to your actual life.

    This kind of thing often happens in families in which the parents are living lives based on different cultural values than those of the contemporary milieu of their children. I do not know if this is your situation, but I have seen this kind of thing in my psychotherapy practice when the parents came from the "old country" and could not understand that their children were living in a new county, in a completely different cultural surround.

    My suggestion is that you keep on trying to educate your parents about your world, the world in which you live. Perhaps you have a good friend who could help you with this project by visiting your home and also speaking with your parents. You also should keep on trying to negotiate with your parents about allowing you more freedom. You might say, for example, "I love you and will continue to respect your wishes, but I would like you to promise that when I turn nineteen, my curfew will change to a later hour, and I hope you will understand that I work hard and need more freedom."

    I wish you all the best in your continuing education, and every success in your chosen career.

    Be well.








    Dear Dr. Robert,

    I am a 39 year old married women who just for the first time in my life had three way sex. I am so confused about my feelings. It just didn't turn out the way that I thought it would.

    I brought my very best married friend home with me on Saturday night after the three of us had drunk all night at her house. Her husband has NO idea that this happened and would probably kill all of us if he knew. ( I should say I know he would!)

    I thought it was going to be more about experiencing more with her but it ended up more about her and my husband. She knows that I am upset and wants to know what is wrong. I now kind of feel like it was a mission just for her to have sex with my husband. She has been with her husband since she was 15 and I know she is missing a lot from her sex life.

    I am the one who allowed this to happen so why do I feel so betrayed? My husband and I have talked several times and he has assured me that is was just a fantasy and has no feelings like that for her. But he also agrees that understands why I am feeling like this. He tried very hard to make it more about me and her but I couldn't get into it after she was all over him first.

    It is just that it now feels like I was played, instead of this being a great fun fantasy for all of us. Would love to hear how you could help me.

    Mary - PA



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    Hello, Mary--

    Although many people try to make sexual behavior be about "love," it really is not; sexual behavior is the expression a deeply programmed instinctual drive which is common, in one form or another, not only to the higher animals such as dogs, gorillas, and humans, but to all but the very simplest plants and animals. If you understand this, then you should be able to understand that your husband, when he had sex with your friend, was just acting on this instinctual programming, which in the male--not just in men, but in the male members of many species--takes this form: "have sex with as many fertile females as possible."

    The males of many species have ended up with this kind of programming as a result of eons of evolution during which those males who had genes for polygamy spread more of their seed, and spread it more widely, than those who tended to be more monogamous. Therefore, more individuals in each subsequent generation had the genes which favored polygamy. As this was repeated, and repeated, and repeated, a kind of filtering or sifting took place, slowly eliminating the male genes for monogamy, and slowly promoting the male genes for interest in any available female.

    The situation for females is very different--almost opposite in fact. Since she can bear only one child at a time, a woman has, unlike the man, no genetic interest in having multiple lovers. In fact, her genetic interest is better served by getting one man who can not only impregnate her, but also stay by her side to provide for and protect her and her baby, thus helping to ensure survival of her genetic material into subsequent generations. And so, just as the genes for monogamy were slowly sifted out of the male population, the genes for polygamy were slowly sifted out of the female population. This is the most basic difference between males and females, and must be understood by anyone who wants to get a feel for human sexuality and its complications.

    Ordinarily, marriage includes a promise of monogamy, and apparently your husband had been respecting that commitment. Now maintaining monogamy requires the male partner to a marriage to work against his instinctual attraction to women in general, and against his natural desires to experience sex with a variety of them. That kind of self-discipline is part of what a man is promising when he says, "I do." But you gave your husband permission to break that promise when you invited your friend to bed with you. Once your permission had been given, it is entirely understandable, entirely expected, and entirely natural that your husband would let himself go with your friend. That's what sex is, after all, a letting oneself go into instinctual mode, and just--forgive the word, but it is apt--fucking.

    The same can be said for your friend. You gave her permission to have sex with your husband when you invited her into your bed. Apparently, and most naively, you imagined that the three-way sex would be more about sex between you and your friend. I suspect that sex with your friend is really what you were after all along--your letter says as much--however, that is another can of worms. But your husband is heterosexual, and so is your friend, so it seems natural, obvious, and predictable that she would focus her attentions on him, and that he would respond in kind.

    As I see it, you certainly were not betrayed, or, if you were, it is you who betrayed yourself, and so, since you have asked me to help you, I suggest you apologize first to your husband for involving him in this mess, and then to your friend whom you have been blaming for something which was no fault of hers at all. After all, this three-way sex was your idea; you made it happen.

    You say that you imagined this would be a "great fun fantasy," but a fantasy is something which, by definition, is not acted out, so this was not a fantasy at all, but a concrete and foolish violation of your marriage covenant. I suggest that you wake up from your "fantasy," stop blaming the others, and accept responsibility for your mistake and for your feelings.

    Be well.












    I am twenty years old, living in England. I had a normal upbringing in a good household. It dawned upon me quite suddenly when I was at the funeral of someone 'close' to me (a man I definitely respected and liked) and I noticed that as everyone was sad, I felt nothing. I didn't feel anything evil, but simply nothing. Looking back on it, I basically faked being sad (in a kind of stoical way because I couldn't cry) because it felt like that is how I should be.

    I was reminded of a program on Anti-Social Personality Disorder I'd seen a bit of, and I did some research online. I am by no means a fool and it did not take me very long to diagnose myself as a sociopath; the evidence was quite resounding.

    These were the things that apparently makes up a sociopath that I immediately identified with:

    I am a compulsive liar, a proficient thief, a good manipulator and actor with a sharp tongue, people regularly call me arrogant, I dislike authority, I am constantly compulsive, I used to terrorise my animals as a child. The best one I read was 'may actually state that their goal is to rule the world', something I've done many a time. There were others, but you get it.

    Anyway, all I can find is help for people dealing with sociopaths, most of which starts and ends with 'get away from him and stay away'. I've also noticed phrases similar to 'a sociopath cannot be helped because he never wants to be helped because he always feels self-righteous'.

    But given that sociopaths are meant to often be of high intelligence, and I am by no means stupid, I do not think that the above quote can be correct, because it suggests that sociopaths are always so self-righteous that they are naive to what they actually are.

    However I, alone, have identified what I am and I understand that I have a complete lack of empathy, and have never loved another human. It's funny to think that I've only just realised I am a sociopath, yet stating that I have never loved in my entire life sounds like something that would be hard to miss. I'm not sure I can describe in words what I thought of myself before I had this online epiphany, but needless to say, this realisation has changed how I think of myself and the world; It's like I'm having an internal philosophical breakdown.

    I am undecided whether being a sociopath is a good thing or a bad thing, given that I don't believe I've experienced the 'normal' way of things. However, all I am wondering is if there is a way that a sociopath can 'learn to love', or at least to change at all, or am I destined to pretty much not care what happens to anyone else for the rest of my life?

    I am truly intrigued to see the response, if I get one.

    Thank you,



    David.



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    Hello, David--

    Judging from your letter, your self-diagnosis of sociopathy may very well be correct. The list of traits you used to reach your diagnosis sounds almost like the classical definition of sociopathy. But while some sociopaths may be naive to their condition, as you wrote, such naivete is not so common. Most sociopaths, lacking the anxiety and guilt which they see all around them, eventually come to understand very well that they lack the conscientiousness and empathic feelings which most people have. In fact, many, if not most, sociopaths have learned, just as you say you did at the funeral, to mimic or imitate the conscientious and empathic behaviors of others in order, for purposes of their own, to fit in or blend in with the crowd.

    In her book, The Psychopath Next Door, Martha Stout opines that around 4 percent, or one person in every twenty-five, falls into your category, so your condition is not so rare as you might think. The American Psychological Association estimate is lower (3 percent of all males), but even using the lower figure, one understands that people such as yourself are found everywhere but normally go unrecognized due partly to their skill in simulating a "normal" personality, and partly to the kind of psychological blindness which causes many people to assume, on no real evidence, that other people are pretty much like them.

    Now to your question. In my experience, there are four main obstacles to successful treatment of sociopathy, 1) lack of knowledge about what sociopathy is; 2) ability of the sociopath to fool the therapist; 3) inability of the therapist to understand the sociopath; and 4) the sociopath's ambivalence and resistance to change. I will take them one by one:

    In the first place, no one understands what sociopathy really is. The term "sociopath" is only a description, not an etiology. In other words, "sociopath" is a name for a person who evinces certain traits such as callousness to the feelings of others, or the ability to use another human being as a pawn without guilt or regret, but saying that name says nothing about the causes of sociopathy. Is sociopathy a disease as the "pathy" in its name implies? Or, since one in every twenty-five people is a sociopath (to use Stout's figure), is "sociopathy" not a disease but a normal human personality variant which, since it served its possessors well in the struggle to survive and multiply, has perdured over the countless eons of human evolution and so persists as part of the psychological spectrum of present day humanity? And make no mistake about it, society may label sociopathic behavior as ""cold" or "criminal," but in many social roles, for many purposes, the sociopath is useful, and society makes good use of him or her.

    This is what leads me to ask if sociopathy is not a normal variant which evolved and endures because it works. For example, in a combat unit, who would be the sniper? Who could sit in a tree waiting all day to kill a perfect stranger in cold blood? The sociopath, of course. Who could be James Bond? But even in more mundane circumstances sociopathy might confer advantages not just on the sociopath, but for society in general. How about a surgeon who can cut into human flesh without feeling anything?--who can do the job, in other words, without hesitation, nerves, or fear. And so, if sociopathy is deeply and genetically rooted in the human psyche, how can it be "cured," or even treated?

    A second obstacle to treatment is the ability of the sociopath to feign, simulate, imitate, and lie. Many sociopaths, if they found themselves in psychotherapeutic treatment, would have no trouble at all pulling the wool over the eyes of all but the very best psychologists. And seeing how easily the so-called "expert" is fooled, the sociopath in treatment would soon lose respect for the therapist (if indeed he or she ever had any respect for the therapist), and with that loss of respect any chance for real therapy would effectively end.

    The third obstacle to treatment is inability of non-sociopathic humans, including psychotherapists, to empathize with the sociopath. In other words, David, although I understand quite well that you lack any deep feelings for the people around you, it is difficult for me to put myself very far into your actual experience, for I always see others, at the most basic level, as similar to myself in the ability to feel pain, and so to suffer. And in my experience this compassion extends not just other human beings, but all beings capable of suffering. It is remarkable to me, for example, that so many humans seem to find sport, amusement, and so-called "recreation" in killing defenseless animals (Dick Cheney), or in prompting dogs to maim and kill one another (Michael Vick), but that's another story.

    Since I once spent a year interviewing rapists, murderers, and other violent criminals at the Penitentiary of New Mexico, I have gotten to know a variety of sociopaths and psychopaths and have listened carefully to many stories, but even so, I never could fully imagine hurting an innocent person, for example, and then feeling nothing--no regret, no remorse, no guilt, just nothing.

    But my therapeutic work rests in large measure upon the understandings that I reach by means of empathic attunement to the inner life of the patient. For example, if a bereaved person comes to me for help, I may not be feeling his or her pain myself at that moment, but I have felt such loss and suffered it, so I can use the recollection of my own pain and grief in those past circumstances as a way of entering the mind of my patient. So if you were to come to me for treatment, and if you told me that you feel nothing much for anyone else, that you can steal, lie, cheat, manipulate, and use people with no guilt or remorse at all, how could I approach our work? Yes, I could understand your words on a logical level, but probably not with much emotional depth. You see the problem here, I assume.

    The last obstacle to psychotherapy for the sociopath is the sociopath's own ambivalence and resistance to change. You suggest this in your letter when you say, "I am undecided whether being a sociopath is a good thing or a bad thing." I admire this statement for its honesty, and for your reasoning about being undecided (that you had no basis for judgment since you did not know anything about what "normal" humans really feel). I think this is the case for many sociopaths: deep ambivalence. On the one hand, sociopathy confers some real and undeniable advantages in life. Think of how many "successful" people: leaders of industry, religious hucksters, lawyers and other professionals, military commanders, politicians, etc. have advanced to those career heights in no small measure due to possessing the very same socipathic traits you mentioned in regards to yourself. In other words, not caring one whit about anyone but yourself seems to work pretty damn well in the marketplace, battlefield, corporate boardroom, or any other place where ruthlessness and the ability to lie, cheat, and manipulate may serve as assets. So why would a sociopath want to change?

    For you, there is some pleasure, I understand, and no small amount of power, in slipping through the cracks, in being invisible, in stealing without getting caught, in manipulating others into serving your ends. But on the other hand, what about love? There's the rub. Although you have never felt love, you are not entirely sure that those who say they do feel love are fooling themselves. As a successful manipulator of people, you know that many humans fool themselves constantly--which is part of why they are so easily fooled by you--so it is tempting to put their "love" into that category too, self-deception, but something in you is just not sure at all. Perhaps there really is a repairable gap in your feelings, some damage that calls out for healing, some brain problem which needs a cure, or some maladjustment that requires a tune-up. And this gap, or lack, or call it what you will, apparently lies in just that area where so many people seem to find peace and fulfillment. So you wonder. And the wondering has grown stronger. And this is what you wrote to me about it: ". . . all I am wondering is if there is a way that a sociopath can 'learn to love', or at least to change at all, or am I destined to pretty much not care what happens to anyone else for the rest of my life?"

    Here is my response, David: I do not know. I do not know if compassion can be taught to someone who says he does not have any to begin with. But I am not prepared to rule it out. Possibly if you had come to me personally with that question I would consider working with you therapeutically, but I would inform you first that that sociopathy has no known effective treatment--not known to me at least--so we would be working ad lib, so to speak, and with no guarantees of anything. Then I would ask for a strict agreement with you about the ground rules of our relationship: prompt and full payment, keeping appointments, absolute respect for my time and professional necessities--that kind of thing--and that violation by you of the agreement would be grounds for my firing you from therapy immediately. If you could live with that, and if you really felt motivated to see if some deeper feelings might be available to you (your words about having an internal philosophical breakdown seem promising as to motivation), we might be able to do something. I just don't know.

    Be well.










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    Dear Doctor--

    Let me start by saying that I love my husband very much. he is the only man that I have ever loved. However, we are having a problem that he does not see. When I met my husband 5 years ago, he lived with his mother in a very expensive house. Like everyone who enters the house, I was very impressed with it. I thought that it was strange that a man in his 40's was living with his mother, but I thought that it was a relationship of convenience. He lived there because she cooked and did laundry for him, so why should he leave.



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    I never really thought too much about his mother. I stayed at the house with him on Saturdays. He has a lock on the bedroom door, and she is downstairs and we were upstairs. I didn't like the fact that he lived with his mother, but I naively thought that if we got married, that we would move into our own place because he would not need her anymore for those household tasks.

    Well, fast forward. He proposed and I accepted. I was never happier in my life. We planned our wedding, and we had a wonderful wedding. But, living in that house with the two of them has forced me into therapy. I am seeing a therapist because I needed some validation for what I have been feeling. I have come to realize that he will never leave because she has created an environment where he is her whole world, and he could never leave her. She made us all sit down and create a budget (yes, she is even involved in our finances), she still does some laundry and tries to prepare food for us.

    Basically, since my husband does not believe in therapy, he will not go with me. I was kind of hoping that by writing to you, perhaps you would write something about unhealthy mother-son relationships that I could show to him. It rips my heart out that I'm not sure that I can continue living like this, and even more so, it upsets me to think of living without him.

    PLEASE HELP ME!!!

    Signed,

    Upset



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    Hello, Upset--

    Unfortunately--and naively, as you said--you have married a person who looks like a man, but who is a child emotionally. You have asked that I write about unhealthy mother-son relationships in hopes that my words might influence your husband, but that is a vain hope. If your husband does not "believe in therapy," why would he be influenced by the words of a therapist, particularly one whom he has never even met? If I had the two of you in my consulting room together and could look this man directly in the eye, I might be able to get some leverage in this situation, but at a distance, with written words only, not a chance.

    The fact is, my dear, that you have to do something about this situation--something much stronger and much more direct than simply "kind of hoping." Now you say that you are in therapy because you need validation for what you have been feeling. OK, therapy often begins that way. Now allow me, another therapist, also to validate your feelings: if I were in your shoes I would feel lonely, disappointed, resentful, angry, and miserable, and you have a perfect right to feel that way too, or any other way you feel about this sad excuse for a marriage. Well, now that your feelings have been validated, I suggest that you use the energy of those feelings to begin to make some changes in your life.

    If your husband will not go to therapy with you, I see no hope for this marriage, and so I urge you to give him an ultimatum: either a serious commitment to therapy aimed at getting him out from under mother's skirts, or divorce. I really see no other possibility. You certainly must not continue to live this kind of life; that would be a kind of living death. So, if he will not agree to make a change, you will have to get over your upset and begin to live without him. Since he is a child emotionally, and his "not believing" in therapy simply a form of denial, all of this is up to you--one hundred percent up to you.

    I suggest that you show this letter not to your husband as you planned, but to your therapist instead. I have not met you personally of course, but based on your letter, I believe that therapy for you should now move onward from "validation" to another level altogether (and if your therapist does not agree, I would be happy to publish his views here on my website). At this new level, three important questions would be considered:


    1. What is there in you that would cause you to love and marry a man who is so obviously infantile?

    2. What stops you from simply demanding that your husband choose between you and his mother?

    3. What will you do to end this marriage if your husband refuses even to see the problem?



    Sorry to have to be so blunt, but I believe you need a wakeup call, and since you choose to write to me, apparently it falls to me to provide it.

    Be well,

    RS








    Hello,

    My question is about my father. For as long as I can remember, I didn't want to say goodbye to him or stand next to him in church. That would mean he would be giving me a hug, but instead of putting his head over my shoulder, as in a typical hug, he would put his head against the skin of my neck. This felt inappropriate and made me pull away. Recently, his eyes have been unable to stop looking at my breasts when we speak.



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    Also, he walked in on me when I was on the toilet, and he remained standing in the doorway, stammering apologies, looking at me. When I left the bathroom, he had stormed out the back door of the house.

    Most disturbing was a dream I had. The night before I was returning to my boyfriend of nine years after visiting my parents and siblings, my father did not want me to go. He said, "You think you love him, but you don't." He had a phone confrontation with my boyfriend and I heard my father say, "Does looking at my daughter make your d--- hard?" Hearing him say this, I felt disgusted and numb. How could my father speak about me this way?

    That night, I dreamed that my father was pulling me forcibly by the wrist to his bedroom. He was naked; I was screaming for Charlie. That was the end of the dream, but it still crosses my mind six months later. Do you think this dream was my mind's way of warning me to stay away from my father? I don't remember any sexual abuse from him, but always felt that the way he hugged me was the wrong way for a father to do that. One other thing is that when we were children and we did something wrong, he put us across his lap and spanked us, very hard, with his hand. If I had children, I'd consider that abuse. What are your thoughts on all of this?

    This sounds like it must be someone else's story, not mine. I'm 29 years old, in love, enjoy my friends; and, as a freelance proofreader, I'm also writing a book. It's not often that I speak to my parents because both of them seem incapable of loving me. What does it feel like for my mother to stroke my hair? What does it feel like to laugh like I normally do or even feel comfortable at all when my father is around? I don't know. My younger sister also went through years of discomfort while near my father. We don't know the reason.

    I appreciate your time and thoughtful advice.

    R.R

    Florida



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    Dear R.R.--

    Thanks for your question, and particularly for having presented it to me it so well. Most often I end up proofreading the questions I receive, and sometimes even rewording them so that they can be understood, but yours needed no help at all. It was not until I got to your last paragraph that I understood: I was reading the carefully crafted writing of a pro. Anyway, a pleasure.

    Now to your question. Without knowing your parents personally, I cannot make an airtight determination, but judging from what you have written, I suspect that your father has strong sexual feelings towards you, has had them for a long time, and that these probably were expressed in various inappropriate ways--not just the ways you have mentioned, but in others, possibly more sinister, perhaps when you were too young to remember. Since you mention your mother's coldness, I suspect either that she is cold sexually, and so he turned towards his daughters as an ill-chosen outlet for his sexual frustration, or, alternatively, that she became aware of his feelings for you, and has been cold towards you due to her own sexual jealousy.

    Certainly the things you mention in your letter such as staring at your breasts, or the vulgar and outrageous question he put to your boyfriend suggest that this man is seriously troubled--wounded, that is, in his sexuality. Since the male brain is deeply programmed to view any nubile woman as a possible sperm repository, many men find their daughters sexually attractive, but most are able to deal with those feelings (to sublimate them, as a psychologist would put it) in healthier ways--ways that do not give their daughters the creeps, as your father's unwanted attention gives you the creeps.

    Your dream is, in my estimation, a fairly accurate representation of the psychological situation between you and your father, and I think you should heed it, but not necessarily by staying away from him. Of course you might deal with this problem by avoiding him, but appropriate and measured confrontation, as I will explain below, would serve your psychic needs far better in my opinion, even if eventually it were to lead to estrangement.

    Judging from your letter, you are a well-balanced, happy, and productive person, so I think it likely that you will not need psychotherapeutic help to deal with this unfortunate, and not uncommon, situation. I believe you will be able to heal a lot of this on your own. Here are my suggestions for approaching this important healing work:


    1. Apparently both parents are incapable of loving you in the way that I know you wish they could. Please use whatever compassion you possess to forgive them and let them off the hook. In other words, although the "inner child" in you wishes that they would love you properly, this is unlikely, so you will do better to put that expectation aside, and simply work on seeing them as very flawed, wounded people who do not have much to give. This is not their fault. No one is to blame for any of this. Believe me, being either one of them is much sadder and more difficult than being you, and being you is all you have to do. They will have to suffer in their own private hells privately, and I do feel sorry for them.

    2. Discuss this matter in detail with your sister and with your boyfriend. Try to be as open and comprehensive in your conversations as possible. Do not hold back. If you end up weeping, that's OK too. In other words, get support for your struggle with this. This is important because the struggle is likely to take both time and patience on your part. Although I have opined that you can do this without professional help, do seek out a good therapist if it feels right to you. In other words, get the support you need, no matter how. This will be important in empowering you to carry out the next suggestion.

    3. Begin to treat your father like the creep he is, and do not mince words; tell it like it is. In other words, do not suffer silently--confront him. If he stares at your breasts, ask him why he is staring at your breasts. If he denies it, do not accept that lie. Tell him that you have seen him staring, do not like it, and will not put up with it. If he touches you in a way that does not feel proper, tell him so, and demand that he stop immediately. If you embarrass him, so much the better. Take the initiative. Put him in his place. Come to your full strength as a grown woman; you are not a child! No woman, daughter or not, should allow herself to be misused by any man--not even a little bit. Do not concern yourself with the outcome of any showdown. Just do it! As long as you stick to what you feel and know, as long as you speak your truth and refuse to accept false denials, you will win all of the psychic skirmishes, even if he continues to deny.

    4. Forget about trying to determine whether or not your father's actions constitute sexual abuse. That is only a legal question. The plain truth is that your father has abused you, and the proof is that you feel abused. In more direct terms, whether or not his treatment of you ever involved genitalia, or inappropriate fondling (or wandered into any of the other areas subject to so much foolish hair-splitting about what is abuse and what isn't) is not the point.

    I am sorry for your suffering. Male sexuality is a powerful force that sometimes goes very far astray of what is needed socially, and when it does go amiss often women and girls end up being hurt by it.

    My best advice to you is this: enjoy what you have--youth, boyfriend, interesting work, good companions--and let the rest of it go.

    Be well.










    Dear Dr. Robert Saltzman,

    I stumbled upon your page this afternoon while trying to get some insight on a dream that my girlfriend has been having lately. I've read some of your advise and thought you might be able to help me out.

    The basics: My girlfriend (23) has mentioned twice now that she has had bad dreams in which I've broken up with her or "left her". She mentioned while describing one of them that she was "begging" me to take her back. The dreams, at least the ones she's told me about were within a few days of each other.

    Some background. We've been dating for over a year and a half now and living together for a year. We've had some typical and unusual hard times in the past dealing with various issues, but overall it's been great. Recent issues have been her "need" to be in control, in other words, at times she can get very controlling and mean when she doesn't get what she wants.

    I've had my fair share of control issues due to her insisting that all of her electronic communication devices such as cell phone and computer be kept completely private and locked with passwords. Although she insists that she has nothing to hide she refuses to let go of these precautions. Leading into a more recent issue that I decided one day to ask her why her voice mail box was full. Long story short, it was very easy to detect that there was something there she didn't want me to hear, since she deleted some messages right before she dialed it to "show" me who had left her messages (not by my request).

    Back to the dreams. The dreams that I mentioned occurred a day or so after this voicemail discussion. She never came clean about it, and my thoughts are that she feels guilty and might realize that it's causing me to distrust her. I've tried to let this issue go even though I know the truth but I feel it's very apparent to her that I feel I can't trust her because of things like this.

    My question is regarding the dreams. Does her having these dreams indicate what she's afraid of? Could this mean that she wants us to break up and go our separate ways? I realized that there are other issues in our relationship other than these dreams, but despite the issues I know that she has the best intentions. Our relationship has had it's up and downs and I don't want it to end, but I fear that this is a sign that something really isn't right.

    Thank you,

    Josh (25)

    Southern California



    Hello, Josh--

    Interpretation of dreams is a difficult art at best, and is totally impossible, in my view, without being able to speak directly with the dreamer in order to solicit her associations to the images in the dream. So I am afraid that I will not be able to answer the main question you put to me. However, your letter touches upon another important issue which I would like to address, and that is the area of trust and control.

    Now you say that your girlfriend seems to need to be in control, and that her expression of this need can get ugly when she does not get what she wants. This makes me wonder why you would want to be with a person like that. Please do not misunderstand: I am not saying that you should not be with a person like that, only that I wonder what else is so great about her that you would find it worthwhile to put up with a woman who wants to control you. This is a question which I believe you should put to yourself, Josh, and try to answer seriously, because the odds are that she will not be able to change this feature of her personality even if you ask that she change it, and even if she wants to change it. Almost always, the need to be in control stems from a deep insecurity which will not allow the person simply to let things be as they are. In other words, the person who needs to be in control, and who becomes upset when she feels that she has lost that control, usually is someone who is afraid to trust life to unfold in its own way--someone who lacks the confidence, that is, that she will be able to cope successfully with changes as they occur.

    Since this is the case, before this affair goes any further--before you get even more involved, more tangled up in your girlfriend's fears, needs, and weaknesses--I believe that you would be well advised to understand that being subjected to her need to dominate emotionally and to her habit of turning mean when that need is frustrated are part of the price you pay for being with her, and that most likely you will continue to pay as long as you are with her. Don't get me wrong, Josh, there is always a price to pay in any relationship--as John Paul Sartre put it, "Hell is other people."--so I do not mean to say that anything is unusually wrong with your girlfriend, only that you should ask yourself if the benefits of this liaison are worth the psychological price. In other words, to stay with Satre's metaphor, is this the hell you want to live in, or would another kind of hell perhaps suit you better?

    If you determine that this game is worth the candle--that the positive returns, in other words, are worth suffering her domination and sometimes meanness--then your letter raises another issue which, in my opinion, needs to be addressed, and right away: this is your need to be in control! What gives you the idea that you ought to have access to your girlfriend's computer and cell phone? Doesn't she have the right to privacy and a private life? Does everything have to be shared? Personally, if I were your girlfriend I would by no means want you to read my email or hear my telephone messages. Some of them have nothing to do with you, I am sure, and some, perhaps, involve things she does not want you to know about, and I see no reason whatsoever that you should know absolutely everything about your girlfriend. Would you also want to follow her around when she goes out alone, or eavesdrop when she is speaking with another person? Where would this end?

    I understand that sexual jealousy is an important feature of many relationships, particularly when the parties to the relationship are young, full of hormonal drives, and not yet fully committed to one another. But as I see it, it is your job to suffer your jealousy by yourself (it is your jealousy after all), not to expect that your girlfriend should never have "anything to hide," as you put it, so that you should be allowed to address your insecurity and jealousy by checking up on her whenever you like. This entire idea about not having "anything to hide" is a bit naive in my view; all of us have things to hide, and most of us are very practiced at hiding them. Perhaps after years of marriage--if you two ever get that far--there would be very little left to hide, but certainly not at the beginning. Suppose, for example, that your girlfriend has been communicating with a friend about some difficult feelings which she does not want to share with you. Should she not have the right to do that? Suppose she is even speaking with a friend about doubts and fears regarding her romance with you. Why shouldn't she be able to do that privately, and keep all of it from you?

    I know you are young, Josh, but it is time to grow up. Sexual relationships are not wide-open friendships just filled with mutual trust and purely altruistic emotions. Sex is a complex battleground where some of the most profound insecurities about loving and being loved in return are played out--often in painful and stressful ways (as you expressed when you said that you two have "had some typical and unusual hard times in the past dealing with various issues."). I have written more about dating and sexual relationships as an egoic battleground in another ask the psychologist letter which you might like to read. A sexual bond may turn, eventually, into a deep and wonderful kind of friendship, but that takes time, commitment and love; it is not at all automatic, and, judging from your letter, you two are not there yet--not even close.

    To put it bluntly, if I have to read your email and listen to your telephone messages in order to "trust" you, I don't trust you, and probably I doubt that you love me or that you really are my friend. And that's where you are with your girlfriend--no trust, no real friendship. As I said earlier, real friendship between sexual partners does not come easy, but it will never come at all if you continue wanting to check up on her.

    If you want a real love, a real amour, Josh, here is my advice: have fun with this woman, enjoy her, do things together. If she burns you, so be it. You will learn from that and move on to better things. If she does not burn you, then you have a real friend. As this is sometimes expressed:

    "How do you tame a bird?"

    "Leave the door of the cage open. If the bird is free to fly, but stays, she is yours."

    Be well.








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    Hi.

    I was wondering if you could help me or not. I am 7 months pregnant and my boyfriend is only obsessed with the lack of sex he is having. The reason for the lack of sex is that when he was scared to be a father he was picking fights with me (for months at a time) to try to push me away and the only thing he wanted from me was sex. He would even get his family to lecture me and let me in on their secrets--yuck.

    I have had a hard past with being sexually molested as a child and raped. I keep telling him that if I feel forced into it then it feels like I am in those situations all over again and he has known this all along so it is no surprise to him. Do you have any suggestions for me on how to deal with him as I am getting to hate the whole topic all together and would rather be without for the rest of my life.

    It is so frustrating to be seen only as a bootie call instead of the mother of his child and a human with feelings.

    I need help ASAP please.








    Christa, 31 years old

    Prince Edward Island, Canada.



    Dear Christa--

    I know that these days many women choose to become pregnant without being married, but in my opinion this is usually--almost always--a mistake. From your letter, it appears clear to me that this man does not love you, has never loved you, and that his principal reason for being with you is pursuit of his own sexual gratification. In other words, as a "girlfriend" you are little more than a sexual toy, and your boyfriend has been using you as if you were a paid prostitute. With the legal, financial, and emotional ties that you would have had as a wife, this type of relationship would be much less likely to occur. In fact, in my practice I advise that young women not even think of sex without reliable contraception unless they are happily married already. In other words, these relationship matters should be well worked through and in good shape before a baby is in the offing.

    Please understand that I feel for your situation, and that these words are meant neither as a judgment nor to make you feel worse than you already do, but simply as an advisory to the many other young women who visit my site and who may benefit from hearing them.

    Although I do not imagine that you will like hearing my advice, nor do I imagine that you will follow it, I will counsel you anyway as you have asked that I do. But before telling you what I think about your problem, I want to repeat what I have written often in my replies to previous questions:

    Here on this site I do not pull my punches. In other words, if you approach me for advice, I will tell you exactly what I think, withholding nothing. I do endeavor to be as kind and gentle as possible, but will neither pussyfoot nor beat around the bush. That would only be a waste of my time and yours. So if you ask a question, please be prepared for an no-nonsense reply.

    That said, here is the advice you asked for:

    1. Get away from this man as soon as possible. I assume that you live together, so in my opinion you should move out and find another place to live right away. Do not even think of having sex with this poor excuse for a man again unless and until you get a serious apology from him for the abuse and mistreatment he has brought into your life, as well as a serious promise that he will not be repeating this kind of abuse. In my opinion, you should refuse even to speak with him unless and until you get that apology.

    2. Find a good therapist--perhaps one suggested by your gynecologist--and begin work on healing your unfortunate past sexual history. Please take my word: with the proper help you can heal this damage, but until you do, you should not even think about being sexual with anyone, including, and especially your boyfriend. Unfortunately, women with your kind of sexual history almost always end up being abused by "boyfriends" until they can come to terms with the childhood abuse they suffered. This is because women who have been raped and otherwise abused seem somehow to attract the kind of men who will be abusive. I have seen this frequently in my work.


    In other words, Christa, if he wants to be with you and with his child to be, your boyfriend will have to come to see the error of his ways, make you believe that he as seen that error and will not be repeating it, and also learn to keep his penis in his pants until you are ready to be sexual again. If he cannot do these things, he's not worthy of you, and you should tell him so in no uncertain terms. To help with this, please take a look at the letter from a women who felt obligated to give her boyfriend oral sex even when she did not want to.

    Possibly this advice will seem harsh or extreme to you, but, as I see it, you were mistaken in getting involved with this guy to begin with, and there really is no reason to compound the mistake be allowing the abuse to continue any longer. In other words, in my view, the sooner you get away from this selfish, ignorant "boyfriend" the better. Getting away from him will have two advantages. In the first place, the abuse will stop; and make no mistake about it: you are being abused by him. In the second place, there is a chance that the shock of suddenly being without you could wake him up to the error of his ways (but that is a long shot).

    If you do have the courage to leave him and so to regain control of your body and your life, please write again and tell me how you are getting on.

    I wish you the very best with your new child to be.

    Be well.






    I am a bit surprised by the large number of letters I receive from people who are not able to let go of a "love" even though they know in their hearts that the "love" is no good. I will publish two of them below, and then answer them both. When you read my reply, I think you will understand why I use quotation marks around the word "love." It is my hope that this reply will serve to answer all questions in this vein.

    RS




    LETTER NUMBER ONE:



    My boyfriend broke up with me about a month ago, and I'm having a really hard time letting him go. I've lost all of my appetite, I feel tired all the time but I can't sleep, and the only thing that comforts me is the thought that we might get back together. I've never felt this way about anyone after breaking up with them. He was my third boyfriend. I'm 23 and he was 18, and we were together for three months. I just want to know what I can do to feel better about myself, how I can let him go. Or, even better, how I should approach him about getting another chance.

    I feel that we were never really close in our relationship, and its eating away at me. I feel like I was dumped before he even really got to know me, or me him. What I want is another chance, in order to try to tear down the walls and build a better relationship.

    After we broke up, I didn't speak to him for a couple of weeks, and then I asked him to meet me for coffee so we could talk about what went wrong with the relationship, He agreed, and met me, and we talked for a while. He never really managed to say what was wrong with the relaitonship, just that he thought that I was looking for something different than he is. After a bit more talk I asked him on a date to see a movie and he said yes. Then, the next day he said he just couldn't convince himself that it was a good idea. I asked him to please come and give me a chance, and he said that he just didn't have those feelings anymore. I know that I should take him at his word and let him go but I just can't seem to.

    Another week passed, and today I started talking to him again, just a simple hey how are you. He said he was ok and asked how I'm doing. And that's where we are at.

    Do you think I should see a psychologist to help me get over this?

    Thanks,

    Nicolas





    LETTER NUMBER TWO:

    Good Day doctor.

    My name is Monique and I am turning 26 in August on the 8th. I live in South Africa (Pretoria).

    I have known Jade since I was in Primary school. We then started dating on High School. We then had a little girl. She will be turning 9 years old on September the 3rd. We are both going through enormous changes in our lives at this stage, and I feel as if I can't handle it anymore. It is too much for me.

    Jade and I were living together for almost 3 years and we have known each other for more than 12 years. He takes other girls and leaves me for a month, then he comes back to me. And I always took him back for the sake of my love and our child.

    Now things are a bit different. I moved out and I am living with my mom, and he still visited and things were going quite fine. He than decided to leave me again after he asked me to marry him (and we had past arrangements of weddings as well). He never keeps a promise .He told me he would not leave us ever. Now he took a girl and it has been lasting for 5 whole months and I don't know what to do. I still love him but I am hurt so much now. Is he still in love with me or not? The girl also has a daughter of 6 years old. He has moved in with them. My child and I are very heartbroken.

    What is wrong with him?

    Or is there something wrong with me. Has he forgotten me already, because I can't. He is in my thoughts, in my dreams. This is also affecting my child a lot. She doesn't want to see him anymore. But what do I do?

    Monique





    Hello Nicolas, Hello Monique--

    First of all, let me say that I am sorry for your pain and suffering. I understand that desiring to be with someone when that desire is not returned can seem like the worst possible luck. And although your situations are quite different in one way (Nicolas' "relationship" never really even began, while Monique has a child with her boyfriend), in another way they are exactly the same. They are the same because neither of you is willing to see things as they are. In other words, and to be blunt, you are lying to yourselves. This kind of self-deception or delusion crops up in so many of the letters I have been receiving that I am hoping to write about this once and for all instead of having to answer each letter separately. In future, I will refer the writers of any letters I receive on this subject to this page. That way I will be able to use my limited time to reply to some of the many questions I am asked about other equally important matters.

    Nicolas, your boyfriend is 18 years old. He is practically a child, and certainly not ready to make the kind of commitment which you are demanding of him. At his age a young man needs to experience many things, meet many people, get to know different women, and not be tied down. Perhaps at 23 you are ready for something more stable, more long-term, but if that is what you really want, you should be looking for someone older than you, not five years younger. Further, your boyfriend has told you--and in a kind and honest way, it seems to me--that he does not feel the way you do. How could he feel that way? He is, as I said, much too young for those kinds of emotions, or at least for those kinds of emotions to last for more than a short time. To be totally clear, a boy of 18, except in very rare cases, is not capable of adult love. Sex, yes. Love--which really means wanting to take care of another person, to devote oneself to her, to live for her happiness, and to always be thinking of your happiness together as partners in this life--no.

    Now you say you want another chance, but another chance at what? Your boyfriend has already told you that he is looking for something different from what you are seeking. Clearly, from your letter, you want a "relationship," and he does not. How much more straightforward could he be? You said, "I know that I should take him at his word and let him go. . ." Right! Exactly! Just do that. It is your only viable possibility, and you will be losing nothing by giving up your dream of him and moving on. After all, as you wrote, you never were really close anyway.

    If you want to spend time and money consulting a psychologist to help you arrive at the obvious (he doesn't want you, and most certainly does not love you), go ahead, but to me that seems like a waste of both time and money, because sooner or later you are going to have to stop lying to yourself--stop telling yourself that there is some reason for you and this boy to be together--and just move on. My advice to you, Nicolas, sounds like the old advertisement for Nike sports shoes: "Just Do It."

    Monique, you are in the same boat, only much worse off, because you made the mistake of having a child with this man who does not love you and probably never really did. I say that he probably never really did because when your "love" was hot and heavy--in high school--Jade was just a boy like Nicolas' boyfriend, probably even younger. He may have been capable of sexual passion, but love? No. This he has proved over and over by "taking other girls," as you put it. What kind of love is that? Now the time to stop lying to yourself has arrived, and I hope you can manage it.

    I say you are lying to yourself because after all his infidelity, after all the hurt he has put you through, even now that he is living with another woman and her child when he already has a child of his own with you--after all that--you still ask me, "Is he still in love with me or not?" Do you not see the absurdity of that question, the emptiness of it? Of course he is not in love with you! He does not even know how to love his own child! He has proved that over and over by his behavior, and it is time to stop lying to yourself, and just accept that sad fact as your daughter already has done.

    Since you do have a child with this guy, you probably will continue to see him and know him for years, so you probably cannot just put him out of your life as Nicolas should do with her boyfriend. But the sooner you admit to yourself that your idea of "love" with Jade was just a dream, just a kind of self deception, the sooner you will be able to begin to put this relationship on a realistic footing which will serve both you and your daughter much better than this fantasy relationship now is serving you. Jade, it seems to me, is not capable of love. Perhaps one day he will be, but not now. All Jade cares about is his own sexual pleasure, not you and not his daughter. Why would you want a man like Jade anyway?

    If you cannot understand this, please get some professional counseling to help you.

    To others in the same situation: if you get the feeling that your "love" is not being returned, it isn't, and my advice is this: don't wait, don't wonder, don't hope for changes. Just move on. Just do it!

    Be well. Dr. Saltzman,

    My best friend's parents recently died (4 1/2 months apart). I have been there for her throughout. We (I thought) were the kind of friends who help each other in times of crisis. Meanwhile, I have been dealing with critical medical issues--34 years of dealing with issues---since I was a child, and I became very anxious, shaky, and weepy before a crucial appointment.

    Almost two weeks ago, my friend and I were on the phone, and I started crying about the upcoming medical appointment. I immediately apologized, but she said she had to go and we would talk later. She did call me on the Sunday before the appointment, but I haven't heard from her since.

    In that last conversation, I told her I would keep her updated and let her know when I was on the way home. The appointment went on longer than anticipated, so I text her. Then, I phoned and left a message letting her know what had happened and explaining that I would have to stay for a mammogram and bone scan the next day. In every call, I asked how she was and let her know I appreciated her ear and she had mine. No response.

    It has been almost two weeks, and I have no idea what to do. Was I too needy? Did I not consider her feelings enough. (By the way, she gets upset if I do not keep her abreast of my medical problems and keep things from her.) I want to be there for her, and I am about to undergo a breast biopsy. How should I handle this? Call her? Leave her alone?

    I am hurt, angry, scared, and concerned about her.

    Please help.

    Liz



    Dear Liz--

    First off, I am sorry for your suffering. Chronic illness is one of the most trying experiences known to us humans, and I wish you the strength to bear it, and that you find your way back to health.

    I understand your concerns about this friendship, but I am afraid that without speaking with your friend directly I would only be guessing about her motives in having become more distant than is usual for you two. My guess, but it is only that--an uninformed conjecture--is that the mourning for her parents has left her less capable than usual of empathy for your own suffering. In other words, perhaps she is so overwhelmed with grief that she has no emotional energy left for any suffering but her own just now.

    To answer your specific question: in my opinion you certainly should communicate with her, and soon. In matters of the heart, I feel that it is always better to know than to guess. So I advise you just to take the bull by the horns, be in touch with her, and arrange a meeting face to face. At that time you will be able to find out how her life is going, express your appreciation for her years of support, and apologize for perhaps having put too much weight on the friendship during her time of loss and pain. When you see how she responds to those words, you will know better what has come between you two, and how to deal with healing it, for certainly a friendship this important must be healed.

    I hope your biopsy goes well for you.

    Be well.






    Hi Dr. Robert.

    Would you please briefly describe the likely adult psychological profile of a girl child whose mother neglects her - i.e. ceases to offer affection and general attention to the child after, say, age two onward (once the child is no longer a cute, adorable little baby anymore). I understand how busy you must be and that assisting a writer develop a fictional character for his book may not be top priority for you - but that is what I'm up to; writing a book.

    Please explain what a neglected girl child might turn out to be like later on in life (briefly, generally).

    Thank You!!

    Keith Clementson

    Artist



    Hello, Keith--

    Since you have been honest about your intentions (you could have posed this as a personal question), I will reward you with a rapid reply.

    In order to develop normally, a child requires a certain "gleam" in the eye of parents and caregivers. Each time the child sees that unmistakable, and unfalsifiable sign of interest, acceptance, and love, the child gains a bit of self-esteem, and each of those special moments adds to the child's sense of self which must be built up, bit by bit, during the first seven or so years of life.

    If the child does not receive this kind of good parenting, the most likely outcome is some form of narcissistic disorder. For example, the adult might always look to others, in unrealistic ways, for appreciation and acceptance, and since these demands will seem excessive to others, she will experience frequent rejection which, you see, is just an unwanted and unintended reprise of her childhood experience. This is how each of us makes our own world, usually unconsciously.

    You can research this kind of thing by googling "narcissistic personality disorder." I am sure that you will find detailed profiles on the web upon which you can base your fictional character.

    I hope this will help, and good luck with the book.

    Be well.






    Hi, Dr. Robert--

    My name is Terry and I live in Saskatoon, Saskatchewan. I am 25 years old and have been dating my boyfriend now for over a year. The problem I am having is that my boyfriend talks in his sleep all the time about a girl he met about 2 years ago. He said it was love at first sight but nothing happened cause she was dating someone else. His dreams have been anything from saying how he would leave me for her to him having a sexual dream about her. I am wondering if I have anything to really worry about or is this just something men do. Please help me to try and figure out what to make of this.

    Thank you



    Hi, Terry---

    Sorry to be so long in replying. I have been traveling, and have just returned to find an amazing backlog of email. This site has now become the world's most popular ask the psychologist website, and I struggle to keep up with the volume of questions I am receiving. To others who have written: I am trying to reply to as many of your letters as possible, but if your question seems urgent, please consider looking for help locally.

    I do not think this is something that “men do.” I think it is something that this particular man of yours is going through. As to what it means: this is difficult to assess without my being able to speak with him directly, but given what you have said about his conscious feelings about this woman (not his dreams, but his recollections of actually meeting her and falling in love at first sight) I do think you might have something to worry about. After all, how can you possibly compete with that scenario (a perfect love lost before it could ever really happen) or go head to head with those dreams (dynamite sex, and not even a wet spot to sleep in afterward)?

    It must be difficult always to be compared to an unattainable, faultless woman. In fact, if I were in your shoes, I might begin thinking about looking elsewhere for the love you want, but since I have not met your boyfriend this is just my gut feeling--the way I might react to being in the kind of situation you describe--and should not be seen as my firm recommendation.

    Be well.






    Hello Dr Robert,

    For many months I have been seeking someone to discuss my situation with. I am pleased to have finally come across your site to have this opportunity to ask you about a very personal issue.

    I am 31, single with no children. Last year after several appointments with a gynaecologist during investigations and eventual surgery, I realised I was falling for my gynaecologist. He is a consultant in his late forties and has always been a perfect gentleman and professional. I have never had to undergo any intimate examination and have had two laparoscopic surgeries so all that needed to be done was done under general anaesthetic. I was initially concerned about developing deep feelings for this man because I was afraid it may lead nowhere and I could end up hurt or frustrated, and I tried to look within myself to understand whether I was trying to project some unmet need onto him--a transference of a sort. However, I have a good relationship with both my parents and had a happy childhood and also already have a couple of older platonic friends.

    I have had to see numerous consultants and doctors in the past due to a number of health issues--many of them have been male but I have always remained on professional and or platonic terms with them, thankfully. It has become apparent, especially since my last operation by the gynaecologist that the attraction is mutual. The fourth time we met he offered to walk me along the corridor, and he has been very attentive to me (more so than he is with another female patient of his that I know who is the same age) and has taken the time and trouble to give me pictures of my surgery (which some patients of other consultants do get, but he doesn't usually do). He also asked to see me sooner than he usually does, and said "I'll see you in two week's time and we'll see how it goes". He also came to see me straight after surgery and told me he'd ring me in the morning. For months I felt on cloud nine--and on one of the most recent occasions when we talked before surgery, we sat side by side and both were perfectly content. I live with my parents and they remarked on many occasions that I seemed to be smiling a lot to myself.

    The bubble burst when I was waiting for that next appointment and as circumstances had it, he was scheduled to be away. I received a very impersonal standard "due to unforeseen circumstances. . ." and had to reschedule. There were only evening appointments available, and I couldn't attend because I work evenings myself, so I had to wait extra weeks for a daytime appointment--unable to explain why or communicate in any way. My world fell apart, and it has been impossible for either of us to articulate what we feel or what's going on because of the professional boundaries which must be maintained. After the last appointment nearly 5 months ago, he was very caring about me getting home. Right after I left the room, I overheard him breaking down behind the door. It's the most desperate sobbing I have ever heard from anyone, let alone a man. I didn't know what to do--I felt so helpless. I had been feeling equally despairing about the situation, but I didn't want to let on to him that it was making me suffer.

    I sent a card the next day, thanking him for doing his best for me--for having found a great consultant I viewed as a friend, No reply. I then waited a couple of months and send a letter updating him on my progress. No reply. I have sought treatment from another doctor (not a specialist, but a medically qualified holistic practitioner) for my condition, and have informed him that I have done this, so that he knows I am prepared to seek care from another doctor to make way for a relationship. I realise that the reason he may not have responded is that he cannot risk being accused of misconduct. Or he may not be interested at all.

    I don't know what to do. It looks as though I've landed the ball in his court--but the rules are preventing him doing very much with the ball. I feel very on edge about seeing him professionally again--and my condition is such that I could require emergency treatment (although hopefully not for many months or years). For example, if I were to meet someone else and become pregnant (which may never happen) I don't know how I would deal with having to face him as my obstetrician now, because of the feelings I have had.

    Should I just forget this altogether or is this worth waiting the requisite time to allow the professional dust to settle?

    I would value your opinion.



    Hello--

    You may be interested in reading my reply to another woman who seems to be falling in love with her gynecologist. If you take a look at that one, you will see that the matter of transference between doctor and patient is more complex than you seem to imagine, involving, as it almost inevitably does, physical closeness and relationship details which are similar in many ways to those between parent and child. Your situation seems different from hers, however, since in her case the physician did not seem to share her feelings, but as I understand your letter, you believe that your doctor is also in love with you but somehow feels constrained from acting on his feelings.

    If you now have another personal physician--if the doctor you love is not your personal physician any longer, that is-- then I am aware of no ethical impediment to a social relationship between the two of you, and so I do not quite understand why you say, having put the ball in his court, that the rules are preventing him from responding. Assuming that he really does have sexual feelings for you as you believe, then it could be that he has other reasons for not taking the initiative (a wife? an important girlfriend?), or perhaps he is just shy about approaching you.

    In your shoes, feeling the way you do, I might be tempted simply to get him on the phone, invite him to have a coffee with you somewhere, and use that occasion to express your feelings for him. After all, what do you have to lose? But you may consider that kind of approach--which has, at least, the virtue of honesty, and might also get you where you want to go--indelicate, embarrassing, too forward, not feminine, or whatever, and so decide simply to keep on waiting and wondering. Only you can know that, and so only you can know how to proceed.

    Be well.








    Hello Dr. Saltzman,

    I spend most of my life dedicated to political activism and volunteer work which comes from a deep seated concern for the state of humanity. Lately I am realizing that I am intensely unhappy and unsatisfied with my life, because I cannot pursue what I love, which is graphic design. I don't find time to pursue any meaningful relationships outside of a few people I work with.

    My question is:

    Is it wrong to give up doing something which is supremely good but makes you unhappy, for something which is productive yet not an amazing sacrifice, if it makes you really happy.

    I am also somewhat religious, and I find it difficult to reconcile the idea that God wants us to be happy with the idea that we should serve him.

    Randy

    Age 24

    Washington DC



    Hello, Randy--

    Your question begins with the words, "Is it wrong. . . ," which is the clue that I am being asked to offer a moral judgment. As I read it, your letter seems to be asking for my opinion on the ethical dilemma involved in choosing between a life of service in which the source of satisfaction is mainly a feeling of having done "good" for the world regardless of whether or not one really enjoyed doing the work itself, or a different kind of life--one based more on spending your time in ways that make you happy even if those ways provide no great contribution to "humanity."

    Although I am interested in ethical choices--and particularly interested in how human beings can find meaning in life beyond the usual absurdities about "God," salvation, the afterlife, heaven, and hell--you should understand that neither my psychology training nor any other special experience has prepared me to be an authority on what is right and what is wrong. In fact, I know of no such authority on right or wrong--no one who can make a list reliably distinguishing all permissible actions from all impermissible ones, or all "good" actions from all "bad" ones--which is one of the reasons why, as I see it, each of us must sooner or later stop relying on authorities, and learn to trust our deepest, truest inclinations in matters of meaning and ethics.

    To put this another way, suppose I would now tell you that in my view to live without pursuing your own happiness and sense of joy is to be only half alive regardless of any "good" you may accomplish. How would that help you? After all, you could just as easily find someone else who would say the opposite, who would say that to live by following your own bliss, as mythologist Joseph Campbell famously recommended, is simply selfish, and that "God" requires us to serve not our own interests, but "His." So how would you choose between those two very different kinds of advice? You would choose, I imagine, by trying to understand the implications of both points of view, and then looking within yourself to see which point of view made more sense to you. Or, you might consider the credentials of each person and decide to trust the one who seems better educated or who has a higher position in the social hierarchy. Therefore, the moral or ethical authority of another person really comes from your deciding to trust the point of view of that person. In other words, the moral authority you seek does not belong to that person, but is really your own moral authority--your own ability to choose what is right and what is wrong--projected onto that person. In the end, it all comes down to you.

    I know that some of my readers will disagree with this, and would say that there is an unambiguous moral or ethical authority called "God," who has expressed the moral rules in holy scripture, In fact, you seem to want to cover that base yourself by saying that you are "somewhat religious." But whence does the Bible get its authority? Clearly from whoever reads it and decides to trust it as the "word of God." Someone else might say that the New Testament is nonsense, for example, and that the real word of "God" is the Qu'ran. Don't you see? It will always be the individual person who sooner or later has to choose between right and wrong. Another person cannot do this for you since eventually you and you alone will have to end up deciding.

    As I see it, people who want "God" or the Bible, or the pastor, or the imam, (or the therapist for that matter), to tell them what is right and what is wrong are like children who want mommy and daddy to explain the world to them. When will you grow up and begin to explain things for yourself? Or will you always be a child waiting for another human being--presumably one more adult than you--to tell you that how you are living is good or bad?

    If you understand this, please simply look into your own heart and do whatever you must to find dignity, meaning, and joy in this brief life.

    Be well.






    Dear Dr. Saltzman,

    I was initially diagnosed with OCD during my early teens, and I have realized that everyone I know that has/had a history of OCD (diagnosed and otherwise) are, like myself, absolutely capable of living their daily lives in all aspects, for example: They go to work, they have personal investments, they make very intelligent decisions on a daily basis, they are very much capable of everything, their only "flaw" being that, in comparison to the little worries of those without a history of OCD, their personal little worries are a bit more magnified to them due to OCD's knack of reminding them.

    Taking above into consideration, seeing as people with a current/previous history of OCD seem very much normal in their daily judgment skills/decisions/etc. as either employees/housewives/investors/decision-makers/etc., wouldn't you say that OCD is a very "normal" trait among many people and is not a "handicap" in regards to OCD patients' soundness of judgment/decision/comprehension?

    Regards,

    [name withheld]



    Dear [name withheld]--

    Thank you for your question. It is a good one.

    According to the Diagnostic Statistical Manual (DSM) which is used by many psychologists and psychiatrists to evaluate patients diagnostically, Obsessive Compulsive Disorder (OCD) may be found in a patient if that person suffers either from obsessions alone, or from both obsessions and compulsions. Obsessions are defined as recurrent and persistent thoughts, impulses, or images which are experienced as intrusive and inappropriate, and which are not simply excessive worries about real-life problems. Compulsions are repetitive behaviors (hand washing, arranging, checking, etc.) or mental acts (praying, counting, repeating words silently, etc.) which the person feels driven to perform in response to an obsession.

    An example may help to make this clear. The person with classic OCD might continually worry that her house will catch fire when she is away from home, and, although she knows that this is unlikely, cannot stop worrying about it. Then, in response to her worries, she might begin, before leaving home, to check the stove to make sure that she has not left it lit. But checking it once will not be enough. When attempting to leave the house, she might get as far as the front door, but then have to go back to check the stove again because she is not totally certain that she really has turned it off. And this cycle of getting as far as the front door, and then having to return to the kitchen might be repeated again and again until, in a really bad case, she cannot leave the house at all. And the really frustrating thing about this problem is that she may be certain that her thoughts are unreasonable, but still she cannot banish them, and cannot help repeating the compulsive ritual of checking the stove.

    In the stove example, the compulsion relates to the obsession in a way that is realistic, but excessive. In other words, checking the stove once might make sense, but having to check it twice, or fifty times, is over the top, excessive and unreasonable. But often the compulsion has little or no relation to the obsession. For example, some religious people are obsessed with the idea that their ordinary thoughts are blasphemous, and may be compelled, for example, to shower or bathe ten times a day in order to deal with the thoughts. Obviously, this is not just excessive, but entirely unreasonable since "dirty" thoughts cannot be cleansed by showering either once or ten times a day.

    To put this more simply, OCD is a mental disorder in which someone is troubled by disturbing thoughts which will not subside, and which cause significant fear, worry, or anxiety. Then, often, in order to try to rid him or herself of these fears, the person begins to perform a repeated pattern of certain rituals which either are excessive or frankly unreasonable. And the person knows that the thoughts and resultant behaviors are excessive and unreasonable. (In the blasphemy example, if the person does not know that the obsessional and compulsive behaviors are unreasonable, that person is delusional, not compulsive).

    Now you say that you, along with others you know who have been diagnosed with OCD, "are very much capable of everything, their only 'flaw' being that, in comparison to the little worries of those without a history of OCD, their personal little worries are a bit more magnified." If this is true, then I would say that you, and the others you mention, have been misdiagnosed, because real OCD is not at all like what you describe. In true OCD, as I have seen this in my practice, the sufferers are not capable of "living their daily lives in all aspects," as you wrote. That is the point: OCD is a disorder, meaning that ordinary life is being interfered with to a significant extent in one way or another. In fact, the DSM makes this completely clear in the diagnostic criteria statement for OCD:

    "The obsessions or compulsions cause marked distress, are time consuming (take more than 1 hour a day), or significantly interfere with the person's normal routine, occupational (or academic) functioning, or usual social activities or relationships."


    Therefore, I would say that either you are minimizing the extent of your distress, or that you do not suffer from OCD, but just a slightly heightened propensity to worry obsessively, which is not OCD at all.

    Now, your letter raises three interesting points which I would like to address. In the first place, you say that people suffering from OCD "go to work, they have personal investments, they make very intelligent decisions on a daily basis, etc." Yes, that is certainly true of most OCD sufferers, except those who lose jobs because they cannot get out the front door of their homes in order to get to work, or spend all their money on unnecessary precautions, or lose important relationships because their partners cannot continue to abide their level of obsession and compulsion, etc. If your point is that OCD does not imply a lack of intelligence or of ethical reliability, I agree totally. But I cannot agree at all that OCD does not handicap, as you say, its sufferers in one way or another. The handicapping is inherent to the very definition of OCD. Again quoting from DSM:

    "significantly interfere with the person's normal routine, occupational (or academic) functioning, or usual social activities or relationships."


    Now, as to the second point: you ask if OCD is not "a very 'normal' trait among many people." This raises the question of what is normal, and I would like to discuss that a bit. To grasp this question fully, it is necessary to understand that the latest advances in genetics, in studies of identical twins separated at birth, and in real-time brain imaging provide convincing evidence that many, if not all, personality traits are inherent to the individual at birth, and that being a "worrier" certainly is one of them. In other words, people are born already programmed to be essentially who they are in many ways. Yes, it is true that environment can make a difference, particularly the early experiences with family and especially within ones peer group, but environment goes only so far, and not at all as far as many people suppose or would like to think.

    In the last half of the 20th century, it was fashionable to believe that heredity was relatively unimportant, psychologically speaking, and that how a child was treated by parents and friends made much more difference. Possibly this was an attempt by some to project the American political ideal, "all people are created equal," onto psychological understanding. Further, in the last twenty years or so of the last century, the argument was advanced that personality was "socially constructed," meaning that human nature was not largely the same regardless of where or when one was born (as now we understand to be true), but that personality was created culturally. All this was a mistake. I argued against it at the time, and am pleased to see that recent information makes untenable the social constructionist explanation of human personality.

    As a psychologist, I can tell you from experience that all people are certainly not created equal psychologically. We are born with most of our traits already in place, and although these can be modified to some extent, either positively or negatively, by early experiences, the plain fact is that some of us are naturally calm and care-free, for example, while others simply cannot stop worrying. And these differences cannot be attributed to environment since studies of identical twins separated at birth show that twins (who are identical genetically, but shared no home environment) are much more alike psychologically and behaviorally than they are like the children in the families with whom they were raised (the children, in other words, with whom they shared an environment).

    But a third point raised in my mind by your question is, I think, the most interesting. Human nature, since it is the result of evolutionary processes which take place only over vast stretches of time, changes very slowly if at all. Therefore, the personality traits we see in present time are the same as they were thousands of years ago. There were calm, sanguine people then, and there are now. There were chronic worriers then, and there are now. However--and this is the point--since culture, living conditions, and requirements for survival certainly do change, a personality type that was useful and successful in the ancient past, might be problematical in the world of today.

    Let me give an example. Some people demonstrate a strong lack of interest in forming close relationships, and prefer to be alone most of the time. This same kind of person often has no particular interest in following social mores and conventions. Perhaps, also, he or she is pretty much unmoved by either praise or blame. This is a personality type called "schizoid," and in modern society, where most people live huddled together in cities and towns, and the structure of making a living resembles a vast, interconnected beehive, the schizoid person often is considered strange, unattractive, and perhaps mentally ill. But in another time, when surviving and thriving demanded other ways of being, the so-called "schizoid" person might have been perfectly adapted. Imagine today's "normal" person, who needs to being in constant contact with others by cell phone, email, or recently by means of "twitter," and, if all else fails will maintain the fiction of human contact by staring at a TV screen. How could such a personality possibly cope with the task of leaving the tribe to go hunting solo for a week or two? For such a task as that, the schizoid personality seems perfectly created. And indeed it was. It was created, by means of Darwinian evolutionary processes, over countless eons during which "schizoid" people were perfectly adapted for certain tasks. Being so adapted, they thrived, survived, and thus surviving were able to produce children who also carried the genes for schizoid personality. That is how we people of today got to be they way we are. Our forebears had certain traits that worked well, and they got passed down to us. So, in a real sense, most, or even all, of what we are is "normal," but that does not mean that all of it works well in today's specialized world.

    There is a lot more to be said about this, but in the interest of publishing my reply to your question, and due to the large backlog of questions I still hope to answer, I will leave it here for present. Perhaps I will add to this answer later, for it seems to me that this topic, what is normal?, is particularly important.

    By the way, my apologies to those who have sent questions to which I have yet to reply. This site has become, thanks to your interest, the number one ask the psychologist page in the world. I am gratified by the interest, but this also means that I receive many more questions than I can answer. Sorry, but I will do my best to reply to as many as possible.

    Be well.











    Dear Dr. Robert--

    I am a 41 year old woman living in Morehead City, North Carolina. My question is: How do I make it clear to my boyfriend that I don't think it's his right to ask me for oral sex when ever he is simply aroused. He thinks I should just want to pleasure him no matter how or when he asks.

    Thank you,

    Colleen Morgan

    North Carolina



    Dear Colleen--

    The way to make something clear to another person is a two-step process. First you must be clear about it yourself. Then you have to state your understanding to the other person in language which will not be misunderstood.

    Are you clear within your own understanding about this matter, Colleen? In other words, are you certain that you do not feel obligated to give your boyfriend a blowjob just because he has an erection and wants to have an orgasm? Please look into this as deeply as possible, for it is not as simple a question as it may seem. For example, perhaps you feel that your boyfriend would look for sex elsewhere if you turned him down when he asked for oral sex, and so your fear of abandonment might be compelling you to provide the blowjob even though you yourself do not desire to have his penis in your mouth.

    Or, perhaps you have never fully understood that sex between lovers is not just a way for one person to relieve himself whenever he is feeling horny, but a form of communication of feelings and desires which goes back and forth between two people like words in a conversation, including, but not limited to, a conversation about horniness if that is part of the equation. If you are honest with yourself, you may find that really you are not clear on this point, for if you were clear on it, I doubt that you would have felt it necessary to seek my advice about this.

    If and when you really do become clear within your own understanding about all this, then making it clear to your boyfriend should be as easy as pie. You simply tell him, using your own words, that you are not interested in having sex of any kind with him unless you also are desiring to be sexual, so that if he wants something physical from you, he will have to make an effort to make you want it too--not just demand it. If he cannot get that picture, start looking for a new boyfriend.

    Be well.











    Dear Dr. Saltzman -

    I sent this question in a few months ago but didn't receive an answer. I thought I would try again.

    I am 45 years old, female, married for 15 years. Last summer, on two occasions, I committed adultery. The man I committed adultery with was a 30 year old coworker. It was strictly physical between me and this other man. I have ended the relationship. What I can't understand is why the sex was so fabulous with my husband afterward. Both times, I had sex with my husband the next day and it was unbelievably great. Do you have any insight for me? I hate to think the only way to wow things in my bedroom is to go someplace else first.

    Desperate Housewife



    Dear Desperate Housewife--

    I do not recall having heard from you before, but I do receive a lot of mail. In any case, human sexuality is very complicated, and I cannot explain with any confidence why you would find sex with your husband more exciting after your episodes of cheating on him. However, I will offer two ideas that occur to me and perhaps one of these will ring a bell for you (but please keep in mind that since I have not met you, and know nothing besides the few words in your letter, these would only be guesses):

    1. Breaking a taboo, such as the taboo against adultery can be exciting, and when you go back to your husband, having deceived him, you are completing the adulterous circle: husband--lover--back to husband again. Perhaps completing that circle makes having broken the taboo more "real," and therefore more exciting, to you.

    2. Perhaps having sex with another man "refreshed your palate," if I can use those words which usually apply to food and wine, so that you were able to experience your husband's body and sexuality not so much as a habit (albeit a pleasant one), but more as if for the first time.

    Be well.








    Dear Dr. Robert--

    Is there such a thing as middle child syndrome and if so what is it? I'm a middle child and as I've got older I've began to suffer from anxiety and depression and have a fear of going out alone, but do if I have to. I've also been very suicidal at times and wondered if this could have contributed to the way I am now?

    AnnMarie, UK



    Dear AnnMarie--

    Some studies have shown that birth order does have an influence on personality. For example, since the oldest child is the only child for period of time, it is held that he or she becomes used to being the center of attention, and that this may persist into adulthood, producing a personality which craves power and influence. The youngest child, according to this way of seeing things, having become used to being smaller, weaker, and less competent than siblings may develop into an adult who expects others to make decisions and take responsibility. The middle child, having experienced neither the rights and freedoms of the oldest nor the privileges and special treatment of youngest, may, according to the birth-order theorists, feel that life is unfair, or that she or he is unloved or less loved than the others, and develop into an adult who suffers from a negative view of his or her lot in life. On the other hand, it is said that middle children, since they must learn to deal with both oldest and youngest sibling, often learn adaptability, and may turn out to be the kind of adults who are good mediators and negotiators.

    In my experience, using birth order to understand personality is not terribly useful. A good psychologist does much better to hear the unique story of the person in question, and to try, by means of deep listening and empathic attunement, to see into the particular inner experience of the patient. If birth order really were important in the personality development of the patient, this will best come out through hearing and feeling recollections about the individual family of origin--not by projecting some generalized scheme about birth order onto the singular personal experience of the patient.

    In any case, AnnMarie, your difficulties with anxiety, depression, and agoraphobia do not, in my opinion, have much, if anything, to do with birth order. After all, countless middle children--the vast majority--do not suffer from these problems, and many first-born, and last-born children do suffer from them. I understand that it might feel comforting to you to find reasons for your suffering in the impersonal facts of birth order, but this would be a mistake, as I see it. In my opinion, no generalized scheme for understanding personality development will help someone like you who needs not theoretical explanations, but the new skills and continuing emotional support which will help you to deal better with anxiety and depression.

    For best treating these two complaints--anxiety and depression--reality-based personal psychotherapy (along with proper medication, if necessary) is the only viable option, in my opinion. The psychotherapy, in my view, ought to deal primarily not with explanations, but with the actual daily experiences of anxiety and depression. In other words, the therapy should not concentrate on asking "why?", but should instead ask "what?", and "how?" "What do you feel when you are depressed?" "How does it feel to go out in public?" These are much more useful and better questions than "Why are you depressed?" (Answer: "I am depressed because I am a middle child").

    In addition, your mention of having felt suicidal tells me that you should stop trying to play doctor to yourself, and instead get some competent professional help right away. Please do.

    Be well











    Dr. Saltzman,

    I have an old friend who I have decided has Passive Aggressive Personality Disorder. I especially see the symptoms in connection w/his relationship with me (two guys, 'non-weird' friendship, just for clarification). The short version is that I need to know how to deal with him. I know that his life is tough right now, and the last thing he needs is abandonment. But I can't just allow someone to run over me. How do you deal with a PAPD (presuming my diagnosis is correct)?

    If you want the gory details, let me know, and I'll try to explain.

    Joey Martin



    Hello Joey, and thanks for writing--

    Although passive aggressive personality disorder once was recognized by psychologists as an official diagnosis, this is no longer the case. In other words, passive aggressive behavior no longer is considered a "disorder," but rather a "style" of relating to others, in which a person seems compliant with the desires and needs of other people, but actually passively resists them, often, but not always, becoming increasingly hostile and angry.

    I think is helpful and useful to see passive-aggressive behavior as a style of relating rather than as a disorder because once someone is diagnosed with a "disorder," either by a medical person or by a well-meaning friend, that person is somehow set apart from the rest of humanity, put in a special category--the sick person--and then will be seen as "less than."

    In fact, the passive-aggressive style is simply another way of trying to maintain the integrity and strength of the fragile ego. In other words, it is a way of standing up to others which is different is style, but not in substance, from dealing with perceived threats by being aggressive ("get out of my face"), by sexualizing situations (Monica "standing up" to the power and superior position of Bill Clinton by means of flirtation and fellatio--dragging him down to her "level," in other words), by coming on as intellectually, athletically, or spiritually, or even racially superior, or any one of the myriad other ways that human beings try to prove themselves equal or superior to their fellows in order to try to protect the frail sense of egoic selfhood.

    I do not need the "gory details," as you say. I will assume that you have rightly observed the passive-aggressive style in your friend, which you will have done by noticing some or all of the following:

    • Procrastination
    • Intentional inefficiency, chronic lateness, forgetfulness
    • Sulking, pouting, withdrawing emotionally
    • Avoiding responsibility by claiming forgetfulness
    • Frequent complaining
    • Fear of intimacy or emotional closeness
    • Trying to control situations through emotional blackmail
    • Making excuses and lying
    • Feeling victimized
    • Sending mixed messages so that one is never sure exactly what was said or what to expect
    • Blaming others
    • Resentment
    • Sullenness
    • Fear of authority
    • Resistance to suggestions from others
    • Unexpressed anger or hostility
    • Making unfair demands on friends and associates


    Since you have compassion for your friend, and wish not to abandon him, I will suggest to you that were I to have such a person in therapy, my treatment plan would entail trying to strike a balance between fulfilling his or her demands (which would tend to support and encourage the passive-aggressive style), and refusing the demands (which would feel like a rejection). Then, while trying to maintain this delicate balance between gratifying demands and frustrating them, I would constantly, but gently, point out the probable consequences of the passive-aggressive behavior (unhappiness, loss of friendships, losing the confidence and trust of others, etc.)

    I know that you cannot be a psychotherapist for your friend, but I imagine that with patience you might be able to help him by following such procedures. If you cannot make a difference yourself, I would suggest that you show this letter to your friend and urge him to get into psychotherapy for a while. With proper treatment, this style of ego-defense often can change into something more useful.

    Be well.









    questioner: I'm 25 years old, and my fiancee is 23. We live in Beirut (Lebanon), but I lived in the U.S. for couple of years. Beirut is struggling between two very different cultures... a very conservative one, and a very western one that is influenced by France. There is almost no censorship in Lebanon... You can turn on the tv at 10 at night, and there you see an x-rated movie... the American rap music is uncut, and you can hear them swearing on the radio... All of the magazines that we get from France, like "Prestige" which is a fashion-female magazine are filled with couples having sex, and naked men and women. I'm a very shy person, and I've never had sex before... It's probably cause I think my penis is too small. Well, nobody can convince me otherwise, because it is.

    My fiancee is a virgin, and she said that she hasn't seen any penises in her life, but I know that's not true because I caught her lying a couple of times. I think she lies to me because she knows how sensitive this subject is to me.

    Anyway, I'm very insecure about the size of my penis, and I'm acting crazy to prevent her from seeing any naked men cause I don't want her to compare my penis to other penises. Well, if the government doesn't do the censorship shouldn't I? I mean if she compares my penis to every other penis that she sees, she'll know that I'm smaller than any of them, and she's going to think of me less of a man. I know this sounds crazy, and I am acting like crazy, but I just can't stop doing it... please help me fast.

    ---[name withheld, Beirurt, Lebanon]

    dr-robert: This is a question that comes up often in psychotherapy, and, believe it or not, I receive more "ask the psychologist" letters on this subject than on any other. Since for many men, particularly younger ones, the size of the penis is equated with masculinity, if a man believes that his penis is small, he may feel that he is less "manly" than someone with a larger penis. Also, he may feel that sexual partners will be dissatisfied with him as a lover, and that they may be inclined to desire sex with a man whose penis is larger.

    Some counselors and therapists try to treat these feelings of inferiority by arguing and attempting to convince their clients that size does not matter, and indeed, an important study by Masters and Johnson (1966) did indicate that sexual satisfaction both for the man and for the woman [this was a study only of heterosexuals] did not depend at all on the size of the man's penis. But I think that argument is not particularly helpful to a man who doubts that his penis is large enough, whatever that may mean to him.

    The argument that size does not matter is not helpful to such a man, in my view, because it is not true. To begin with, on a purely physical level--a mechanical level one might say--as long as the penis is not too large (so large, that is, as to cause discomfort to the woman) a larger penis will stimulate more of the woman's vaginal erogenous zones, and so will tend to produce a greater level of arousal. But this is just a matter of friction, and good sex involves much more than friction, of course. On a more mental level, there is in human beings a tendency to appreciate things for their size alone--not just the penis, but almost anything--and so, just as there are men who imagine that women with large breasts are somehow "sexier" than women with smaller breasts, there are women who simply enjoy fantasizing about, looking at, or touching larger penises, and believe that a larger penis makes a man more attractive. These are facts, and there is no advantage in disputing them.

    Now, since you believe that your penis is too small, and since believing this has caused you, as you wrote, to behave in a "crazy" way, I believe that a more helpful approach would address your feelings in particular, and not simply deal in generalities about whether or not size matters. I will attempt to do this, but I do want to say first that a written answer cannot provide the counseling or psychotherapy you need. Based on your letter, I believe that you will require professional therapy to heal this tremendous and irrational wound to your self-esteem, and I urge you to seek that kind of therapy as soon as possible, certainly before marrying your fiancee, which you should do, in my view, only when you are feeling happy about the relationship and secure in it. I imagine psychotherapy of this kind is available in Beirut. For your sake, I hope that it is.

    To begin with, I wonder how you came to believe that your penis is not large enough. There is, of course, a great variation in penis size, just as there are great variations in most physical dimensions of human beings, but the situation with the penis is confusing, and different from the situation with other bodily dimensions, and I want to explain why. The average length of the flaccid (that is, non-erect) penis has been found to be around three inches (7.5 cm.) or perhaps a little more. Some penises are much larger, and some much smaller, but a curious fact about the penis is this: penises which are smaller when flaccid, increase much more in size when erect than do larger penises, which tend to increase less in size when they become erect. In other words, penises which are larger when soft, usually do not increase much in size when erect, but penises which are smaller when soft, can increase greatly when erect. This is why the vast majority of penises, when erect, measure around six inches (15 cm.), more or less, in length, even though when flaccid there is a substantial variation in size.

    Now, for a man who is worried about the size of his penis, this unusual fact is important to understand, because many men, particularly heterosexual men, have had little experience in seeing other men with their penises in an erect state. Normally, one sees others' penises in the locker room or shower room, or perhaps standing at the urinal, times at which those organs are in the flaccid state in which any variation in size is much more pronounced. Other factors come in to play here too. A smaller man's penis will seem larger than the same size organ would on a larger man. And the penis of a man with a flat belly will seem larger than that of a man with more fat around the middle. The point is this: if a man has observed other men's penises mostly in the flaccid state, he really does not have as much basis for comparison as you might imagine. A man's penis may appear smaller than many when flaccid, but might "catch up," at least part of the way, when aroused.

    In your case, although you may have not seen them "in the flesh," you have looked at many erect penises through having viewed pornography, possibly more of it than was really good for you. But for various reasons looking at pornography does not provide a good basis for comparing your penis size to the normal or average size. To begin with, the producers of this stuff have an almost unlimited population from which to select men whose penises are unusually large (just as they can select women with unusually large breasts if desired). They can select also for the kind of lean, flat-bellied physique which emphasizes the penis. And then they can use all kinds of tricks of the trade such as trimming the pubic hair to make the penis appear more prominent, or selecting certain camera angles or certain lenses to exaggerate the size of the man's organ. In other words, if you are comparing your penis to the ones you are seeing in pictures, you are treating yourself and your penis unfairly.

    As I say, the average size of the erect penis is around six inches (15 cm.). If your penis, when erect, is anywhere near that size--four and a half inches long (11.5 cm.) let's say--you are within the average range. The following chart, based on penis size measurements of more than 10,000 men collected by the Alfred C. Kinsey Institute, makes this clear:


    ask



    For, as the chart shows, almost all men have erections which measure between four and a half inches and eight inches long. Perhaps, like many men, you wish your penis were larger, and imagine you would have more self-confidence if it were, but please remember that almost everyone wishes for personal assets of some kind or another which he or she imagines are lacking: better looks, stronger muscles, more athletic talent, a higher IQ, larger breasts, and on and on. Yes, in a certain sense a large penis may be a social asset of a kind, but so is a warm and winning smile, or a way with words. At some point, all of us must learn to accept ourselves as we are, including one's body, one's thoughts, one's fears, one's desires--all of it.

    Of course, this is easier said than done, and that is one of the main reasons why good professional counseling or psychotherapy can be so helpful. One of the results I find in almost all the counseling and therapy work I do is that my clients improve, sometimes dramatically, in their ability to accept themselves as they are, and in their ability to enjoy being themselves regardless of whatever limitations they may believe they have. Once again, I feel quite certain that you would benefit from this kind of psychotherapy, and I urge you to seek it.

    Now, suppose the size of your penis when erect really is much less than normal--in other words, that you are correct in saying that you have a very small penis--then what? Once again, truth is best, so I will not make that tired old argument that size does not matter. If your penis really is very small, the plain fact is that you probably will not be any woman's ideal sex fantasy. Not every man can be James Bond after all. But that does not mean that you cannot be a fine and effective lover who can satisfy a woman, father children if you like, and have a happy marriage. This is where the Masters and Johnson study which I mentioned earlier comes in. Although there really are some woman for whom a large penis is very important, they are in the minority. For most woman I have known, both personally and professionally, penis size is way down the list of what makes a man attractive. Personal qualities such as intelligence, kindness, understanding, sense of humor, ability to enjoy life, ability to love and be loved in return, capability to earn a living and to be independent, willingness to take responsibility for the welfare of another person or a family, and many other personal qualities, usually rate much higher on the list than penis size. Skill and tenderness in lovemaking also will rank much higher on most women's lists than penis size, and this skill depends on being able to care about and to tune into a woman's feelings, on being able to use your body--all of it, not just your penis--in order to give her pleasure, and on being able to delay your orgasm until she really is pleased. If you can learn to do these things, she is likely to be happy in bed, and so are you. For further advice about how to love a woman, please take a look at this ask-dr-robert reply.

    Since the size of your penis cannot change (unless you believe all those spam e-mails which promise a bigger organ if you will send money), the most positive thing to do, as I see it, would be to work on those other areas instead. If you develop some of those qualities which women find so important, it is quite likely that you will find a woman who will want to love you and your penis.

    Now this woman may or may not be your fiancee, and that is why I agree with you that attempting to keep her from seeing other men in the nude is "crazy," as you put it. You know, I think that I really do understand some of your feelings about this matter, and they aren't "crazy" at all. No one likes to be compared and found wanting. We all want to feel good about our bodies, and many men wish for a larger penis, just as many women wish for larger breasts or a better figure. The "crazy" part--and that's your word, not one I usually use--lies in imagining that you can have a happy marriage while constantly fearing that your fiancee may see a man naked, and so finally learn that some men have larger penises than yours. I am concerned also that your doubts about your fiancee's honesty might grow and become unmanageable if you do not address this situation before committing to marriage.

    A much wiser course of action, in my opinion, would be this: sometime soon when you are alone with your fiancee and feeling intimate, you might say to her, "You know, I have always felt that my penis is not large enough. It really bothers me, because I know that some men have penises which are bigger than mine." You would say this in the spirit of trying to open up a conversation on this topic. If you can handle this, I imagine that it might help both of you a lot. If you feel that you cannot handle this level of honesty and self-disclosure, some good professional counseling or psychotherapy will help to prepare you for it. Again, I hope this kind of therapy will be available in Beirut. I want to recommend also that before going any further with marriage plans, you and your fiancee get some premarital counseling with a competent couples counselor. This work should include a discussion about sexual needs and sexual desires, both yours and hers. I hope you will understand that these cards must be on the table if you want the best chance at marital happiness.

    Be well.








    Hi Dr. Saltzman,

    First of all, thank you for providing the wonderful resource. I would prefer if the following question is modified if you are going to share it on the web.

    I am an attorney, currently in a serious relationship for almost 2 years that seems to have come to a standstill. I'm interested in moving forward towards marriage, but I have significant concerns about my boyfriend's home situation, and am not comfortable with engagement right now.

    My boyfriend and his father are extremely close, and it took me almost 2 years to recognize this as "textbook" enmeshment. The father is extremely needy of his only child's attention, and essentially unable to function as an independent adult. He is very isolated, has no friends (other than my boyfriend), and does not seek companionship. The two are in constant (every 2-3 hours) telephone contact. The father frequently belittles his ex-wife (the mother of my boyfriend) to the point that my boyfriend has nothing but contempt for the woman. Their divorce was 7 years ago, but she is still blamed for anything- quite literally called "the root of all evil". While I've never met her, this struck me as very unusual from the beginning (sharing excessive details about their divorce with his son).

    Most recently, my boyfriend and I went on a vacation, which we had planned for months. Upon return, we had hell to pay from the father. All kinds of irrational things were said- for example, he stated that we were his only contact, and it was unfair for us not to have left an international contact number. He claimed that he could have died and nobody would have known. Unfortunately, I stepped where my feet do not belong, and pointed out the fact that he has several siblings that live in town, and his concerns about dying spontaneously during our week of vacation are completely unfounded.

    While I clearly overstepped my boundaries, I now see this as a very classic father-son enmeshment/co-dependency, with probably parental alienation of the mother. I'm worried that our relationship cannot continue to grow, and I don't know how to mention any of this to my boyfriend. Do you have any suggestions about how I can approach this situation? It is difficult for me to seek advice from my local community without jeopardizing anonymity.

    Your input and advice are greatly appreciated,

    Kindest Regards,

    -GR



    dr-robert:

    Thank you for your kind words about my website. Judging from the amount of mail I have been receiving, and the popularity of my site, the opportunity to ask a psychologist questions about life and about the art of living is one that people need and appreciate. Since others will have situations similar to yours, I will disguise your identity in order that your question might be published on my site, and so made available to others who have questions they would like to ask a psychologist about co-dependency and psychological enmeshment.

    Judging from what you have told me about your relationship with your boyfriend, this is, as you say, a textbook case of enmeshment. For those who are not familiar with this word, the term "enmeshment" comes from family systems theory, popularized by Salvador Minuchin in his 1978 book, Psychosomatic Families: Anorexia Nervosa in Context, (Cambridge, MA : Harvard University Press), in which he refers to a condition in which two or more people weave their lives and identities around one another so tightly that it is difficult for any one of them to function independently. The opposite extreme way of relating, detachment, refers to a condition in which the people are so independent in their functioning that it is difficult to figure out how they are related to one another. Healthy relationships are thought to be described by the space between enmeshment and detachment. In other words, the best relationships take place between those with independent personalities, those who have a firm sense of one's own separate existence, one's own value, one's own abilities. Ideally, these would be people who are not too terribly intertwined, and yet can function interdependently too: mattering to one another, caring for one another, sharing with one another, and helping one another meet the challenges of living.

    Seen from this perspective, it is clear that the relationship between your boyfriend and his father is not a healthy one. Thank your lucky stars that you have been able to discern this for yourself at this relatively early stage in your relationship with this man. Imagine how much worse things would be now if you already were married, perhaps with a family of your own, and then came to this understanding. Now, the question remains: how to deal with this complicated situation? It is important that you understand that the problem behavior is not located within your boyfriend's father's personality, but rather that this is a shared personality disorder, sometimes referred to as "co-dependency," which is located at the intersection of the personality of your boyfriend's father, and of your boyfriend's own personality (when I say "personality," I mean his way of relating to the world). In other words, your boyfriend, being enmeshed with a co-dependent person who is obsessed with controlling his behavior even to the point of trying to deny him a carefree vacation, is part and parcel of this co-dependent personality disorder, not separate from it in any way whatsoever.

    In fact, your boyfriend, being involved in this co-dependent dyad, most likely also does not have a firm sense of his own value and abilities, and this leads me to wonder to what extent you, yourself, may suffer from this lack of self-worth and self-realization. After all, you have chosen to be involved in this situation, and you have remained involved with it for some time now. Please take an honest look at this, and if you see problems, get the therapy you need to clear them up.

    As things stand now, if you go further with this relationship, your future is easy to divine: you will be dealing permanently not with one person--your boyfriend--but rather with a co-dependent dyad, father-son, in everything you do, and in everything you hope to do. In other words, if you continue this love affair with your boyfriend as it now stands, you are likely to end up frustrated and extremely unhappy regardless of how gratifying sex and other intimacies between you and your boyfriend may have been so far.

    As I see it, you have two viable options. First, you can break it off with your boyfriend. To gain the courage to to this, simply look at the situation with clear eyes and ask yourself if you are ready to live for years with no privacy, no real intimacy, and a constant struggle with what is, in effect, a relationship not with one person, your boyfriend, but rather with a psychologically handicapped dyad. If the answer is no, perhaps you could just let it go, and move on. If you were my patient, I probably would counsel you to consider moving in that direction. But judging from your letter in which you wrote, "I'm interested in moving forward towards marriage," I imagine that you will not follow that path, and that is OK too, as long as you do not let things rest as they now are.

    In other words, the other viable option is to put the matter to your boyfriend in no uncertain terms, so that he will understand that his relationship to his father is terribly unhealthy, and that if he wants to continue moving forward into a shared life with you, he will have to make a change--a change that, no doubt, will require a period of intensive psychotherapy, and considerable suffering.

    In my professional opinion, the middle ground, where you try to deal with this co-dependent relationship without rocking the boat, without putting the matter clearly and unambiguously to your boyfriend, would be a form slow masochistic suicide for you. Sorry, but on this page, I calls 'em as I sees 'em.

    A recent film, called "Love Actually," presented this kind of co-dependent relationship, not between a father and son, but between siblings. In this film, a young woman is in love with her coworker. After months of shyness, she eventually ends up bringing him home for sex, she is overjoyed to have him there, and they begin to make love. Unfortunately, their intimacy is interrupted by telephone calls from the woman's brother, an institutionalized, mentally ill man, with whom the woman is so enmeshed that feels she must answer his phone calls regardless of what she is doing at the time.

    I suggest that you rent a video or dvd of this film and, without preamble, simply watch it with your boyfriend as if it were simply an evening's entertainment. Afterwards, you could mention and try to explore the particular vignette to which I refer, with a view towards leading your boyfriend towards the idea that his relationship with his father is similar to the problem dramatized in the movie. If he rejects this, you are in trouble. If he is able to accept it, at least in theory, tell him that you love him, and wish to support him in getting the therapy he needs to break out of his sick, co-dependent relationship with his father. And then, be prepared for at least a couple of years of pain and suffering.

    I hope this will help you, and I wish you the best in handling this painful and difficult challenge.

    Be well.









    Hey there,

    My girlfriend is recovering from an eating disorder, which completely consumed her for 5 long years. She "woke up" about a year ago, well before I met her, and is doing really well in recovery .. seeing a dietician to help her get back a healthy perspective on food, and seeing a therapist to help her with the emotional issues an ED brings with it. She has told me that during her ED, it consumed her so completely, and that as with any addictive behavior, the ED caused an inability in her to really feel anything emotionally .. for others as well for herself. Her therapist is helping her regain the ability to feel, to communicate emotions, to mend the emotional damage caused by her ED. I have to say she is making tremendous progress. Even though I can tell that she has trouble communicating directly to me how much she cares about me, I am observant enough to pick up on how she does communicate her feelings thus far. In fact so much so that I can truly say that I have never loved or been loved with this intensity in my entire life .. and I have been married before.

    I am a person of exceptionally high emotional intelligence myself, so I can be with her and be supportive of her without making the ED out to be any bigger deal than it is. We both know that there is more to her than her ED past. She and I connect on a deeper level, I feel. After she met me, she has made huge progress in terms of recovery. Feeling how I truly care for her, she says, has done wonders for her. She tells me that she has never been able to feel like she feels prior to meeting me. Of course I'm flattered, but I am making sure that she understands that I'm not with her because I view myself as her "savior" from the emotional void that used to be her life. I want no such power over her, and have told her so. Likewise, because she has recovered so well, she is able to communicate to me in such a way that I sincerely do believe she is not in love with me because she feels like I have saved her. I am not worried about her true feelings for me, as hard as they are for her to communicate.

    What I am concerned about is her relationship to sex .. something I don't believe she has yet covered in therapy. She had her first sexual experience during the vice-like grip of her ED. I know that an ED is similar to any other addiction, in the sense that it can cause you to to develop a warped perspective of reality. When she had sex for the first time, she told me, the guy was being pretty rough .. hard sex, scratching, biting .. and she liked it. Nothing I would consider unusual since pain and pleasure can go very well hand in hand. She has only slept with 4 guys, all while still under the cloud of her ED. It is evident to me from what she has told me, that her prior boyfriends did not really care about her at all as a person.. that it was all about the sex for them. Essentially they used her for sex, they just fucked her hard and that was it for them. She knows this, and has told me so.

    What I am concerned about is that she only THINKS she likes it that way because this is all she knows. She is now unable to really enjoy slow sex, gentle sex, gentle touch. She has never been able to orgasm from having slow sex, and now she only orgasms from heavy stimulation of her G-Spot. I am concerned that with so many other distorted perceptions on life and relationships, which she developed during her ED, her perception of sex is no exception since all of it happened during her ED. When we talk about sex, I do understand that she likes it a little rough .. I do too sometimes, but I can personally enjoy all the various facets of sex. However, I get the feeling that she does not have a healthy perspective on sex. I can tell she becomes frustrated when we have sex and she can't orgasm ... when she gets close but can't quite make it over the edge.. as if it is something that HAS to happen quick. As if sex is all about going through the motions and then orgasming .. that there is nothing more to sex than that. That makes me think that she is not truly able to enjoy sex in all its facets .. her prior experiences are so one sided .. rough .. and they happened during a time when she was not truly within her senses, that it feels to me like sex for her is just another thing her recovering mind is trying to control. She is neither dominating nor submissive. It just feels like, to me, that when it comes to her sexual side, she hasn't made any recovery, and still thinks sex is power struggle .. she has told me that when she has rough sex, it makes her feel she's in control .. I assume her logic is that she feels that way because she is the one who is allowing a guy to do what she (falsely, I believe) thinks is his greatest fantasy .. porn movie sex. That she can give him this, she can deny him this. Power. To me that doesn't seem healthy, and I don't want her to feel like sex is something I do to her, or something she does to me. To me sex, in all its facets, is about intimacy. I don't feel she can appreciate that, and I don't think she's aware of it either.

    I have talked to her about slowing it down, that I want to teach her about sex, and help her develop a different, gentler, healthy perspective. She says she really wants that .. wants to be able to enjoy it the way others can, the way I can, to be free once and for all from all the distortions caused by her ED. She tells me that sex with me is the best she has ever had, that I'm so responsive to her body that it is a whole new experience for her. And I truly do believe that .. I know I'm an attentive lover. It's like I've opened the door for her to enter into a world of a healthy sex life, without power issues, without control issues .. she just has trouble walking through that door. And so she becomes frustrated because she can feel how much more sex can be .. she just can't physically become more sensitive just like that.

    I know that many men would consider me lucky that my girlfriend is into hard and rough sex. I can appreciate that to an extent. Only I find that I can't enjoy it as much, knowing that she doesn't know any better, knowing that sex was something she was being used for. I am most certainly not like those other guys, and she is not the same as she was then. I want us to develop a healthy relationship to sex, together, and I feel she still has a mental block that is in the way .. as if rough sex is enjoyable to her only because her memories of it are linked to her perceived idea of being in control .. In that sense, she is not really enjoying the sex, she is enjoying the comfort of being in control of something that just happens to come with an orgasm .. which I can understand, since an ED is all about feeling in control, in power. I just don't want her sex with me to be associated with the sex she has had before we met. Although physically similar, I want it to be emotionally different .. truly gratifying for her.

    My questions are: 1) has her sex life indeed been warped by her abusive boyfriends and the fact that she was clouded by an ED while it happened? 2) What can I do to help her unlearn what she thinks she knows about sex, and teach her how much more enjoyable it can be?

    I make it a point to touch her a lot .. gently .. and to tell her to just try to focus on how that feels, to try to let everything else go and not worry about what's next, not worry about sex or orgasms .. to try to let my touch become sexually arousing however long it takes, to just enjoy the feeling of my touch. When she touches me gently, and sees how much it arouses me, she becomes almost jealous and most certainly frustrated that she can't be the same way .. that she can't enjoy something that gentle with the same intensity as me. After meeting me, she knows there's a better way .. she just has trouble finding it. I really don't want any of her negative perceptions from her past to be projected onto me, or our relationship. I want her to be able to let all of that go, and to rediscover herself with me by her side .. free from the past.

    I hope you can help shed some light on this for me.

    Sincerely,

    Rune



    Hello, Rune, and thanks for your letter:

    From what you say, it seems as if your girlfriend is making good progress in her recovery from the eating disorder, and I imagine that your gentleness and friendship are important to her at this time.

    I will go on to answer your two questions, but there seems to be in your letter an underlying assumption with which I do not agree, and I would like to address that first. You say that ED is "like any other addiction" as if all addictions were somehow the same, but, in my experience, this is not the case. To begin with, addiction to a substance which produces chemical tolerance is not at all the same as addiction to a behavior which one compulsively repeats (masturbation, for example), but which does not produce chemical dependency. Secondly, one person's experience with any particular form of addiction may be very different from another's. For example, one person may fall into anorectic behavior largely as a defense against being approached sexually--the underlying psychic economy being, in this case, the idea that if I have no breasts, no bottom, no one will want to pursue me with the idea of seduction. Another person may have a similar relationship to food, but the underlying psychodynamics could be entirely different--for example, a teenage girl may buy the "thin is beautiful" image which is promulgated so widely in the fashion industry, and simply pursue it to excess, eventually losing any realistic assessment of her own body. As you can see from these two examples, the directions are opposite, the first an attempt to be less attractive, the second an attempt to be more attractive. Yet a third person may use anorexia and/or bulimia as a way of blocking out disturbing feelings, or of self-medicating against depression since the neurotransmitters released as a result of starvation may produce antidepressive side effects. And these are just a few possibilities.

    To put this another way, please do not be too sure that you understand anything about your girlfriend's behavior. In my view, you would do better to admit ignorance, and simply approach your girlfriend as you would any other human being--as a mystery, that is.

    Now, to your questions:

    1) has her sex life indeed been warped by her abusive boyfriends and the fact that she was clouded by an ED while it happened?

    In the first place, judging from your account, her previous boyfriends were not what I would call "abusive." They "fucked her hard," as you put it, and she enjoyed it. That does not sound like abuse to me, unless you are using the word "abuse" to mean any kind of sex except that based on deep love and commitment, which, to me, would expand the definition of abuse beyond any useful range. In the second place, everyone's sex life is "warped" in one way or another. Our sexuality is warped by absurd religious perspectives, by the use of sex to sell political ideas and commercial merchandise, by the foolish standards of so-called "beauty" which are enforced by cultural hierarchies, by the identification of penis size with "manhood," and of breast size with "femininity," etc. ad nauseum. I would say that the "warping" happened for your girlfriend long before she met any of the "abusive" boyfriends, and may very well play a part, perhaps a large part, in the etiology (development) of her eating disorder. In other words, you may have the cart before the horse here. For example, if I had a patient who had manifested self-starvation (I am assuming that this was the ED of your girlfriend), I would not be at all surprised that she also liked rough sex. Starving oneself seems pretty rough to me! Once again, the message here is for you please to be careful not to assume that you understand more than you really do.

    2) What can I do to help her unlearn what she thinks she knows about sex, and teach her how much more enjoyable it can be?

    From what you have written, you seem to be doing pretty well. Kindness, along with non-judgmental openness to another's experience is, by my lights, the best approach to helping anyone with anything. But I wonder if you are a bit too focused on helping, and not enough on just being. If your girlfriend enjoys rough sex, and has enjoyable orgasms as part of it, why try to wean her off it? Is it really so important to focus on what makes her come? Might it not be better to give her whatever she desires in bed, and make the relationship tender and sweet? With that approach, which simply recognizes that sex is sex and ought not to be measured or judged, you might find happiness together, and perhaps the sexual tenderness you desire would develop on it's own. To me, that would be the path of a really good lover (but that's just my opinion, and you may disagree).

    Be well.








    Dr. Robert,

    I am having a dilemma on what to do about my brother in law. He has been drinking for years and he used to be a fun easy going guy. He used to be full of confidence and people used to like being around him. Now he has become mean and angry and spiteful. He says mean things to his wife , his daughters and his friends. He has gotten into fights and most of the time nobody wants to be around him when he drinks he has become such a mean drunk. I know he is a nice guy somewhere deep down but I don't see it much anymore.

    This week my son lost his girlfriend and he said "well its all her fault for pulling on the highway at night." He didn't have any facts and he made it sound like to talk like that was normal . This pissed my husband off and he told him to get out of our house, they called each other names and then he left. I don't know what to do. He doesn't seem to have a heart left and he is becoming so cruel with everyone around him.

    Christmas around their place has become a big fight and full of vicious things said to his wife and to his kids. He drinks everyday now, but not to the excess of passing out. He just gets verbally abusive. He was nice at one time. His kids are worried and now he wants to go to parties with them (they are 16 and 18 years old.) They don't want him to come but don't have the heart to say no. They have been humiliated quite a few times in the past couple of years from watching things that he has done. I know it is none of my business but I also know that at Christmas time he gets worse and I am afraid he is going to snap. Is there anything that any of us can do?

    (Concerned) Anita





    Hello, Anita--

    Judging from what you have written, your brother-in-law is an alcoholic. (I define alcoholism as any use of alcohol which produces obvious negative effects in the daily life of the drinker.)

    Usually, alcoholics continue to drink, and continue to suffer the effects of their drinking at least until it becomes clear to them that their addiction is out of control, and is costing them too severely. Sometimes this happens in a dramatic way, such as an automobile accident, a spouse leaving, or being fired from work. Occasionally, but not very often, the drinker will simply tire of all the hang-overs, missed opportunities, and other hassles, and then will seek help on his or her own. A third path to the drinker's seeking help for the alcohol addiction is an intervention organized by the friends and family of the drinker.

    An intervention is a confrontational meeting used to help an alcoholic overcome his or her denial of alcoholism and begin treatment. Before the intervention, the alcoholic's family, friends and possibly his or her employer must overcome their own denial. They must acknowledge that there is a serious alcohol problem. They must be ready to stop making it easy for the alcoholic to continue with his or her behavior. They must decide it is time to get serious and practice "tough love."

    It was formerly thought that an alcoholic had to "hit bottom" before he or she would accept treatment. As I said, this might mean losing a job, having a spouse leave, going bankrupt, getting arrested, or experiencing some other catastrophe. But sometimes, by intervening early, such losses may be forstalled. The planning for an intervention begins with a series of meetings with the "team." The team consists of the counselor, family members, friends, and concerned persons. Team members must attend all counseling sessions. During these sessions, a careful strategy of confrontation is planned. The alcoholic will be invited to attend only the final meeting.

    The first step to helping someone with alcoholism is to learn as much as possible about the disease. You will want to know how alcohol affects the body and why alcoholism is a disease. You will begin to understand why the alcoholic continues to drink. By understanding, you will be able to approach the alcoholic without judgment. This will make it more likely that he does not get defensive and refuse to accept treatment.

    Before the alcoholic meets the team, a specific treatment program is selected. The counselor will assess the severity of the alcoholism and will make recommendations for a treatment program. Even alcoholics who deny their problem can be helped with intervention. Be sure to find a counselor who is experienced with intervention.

    Apart from this tactic, there is little more that I can suggest, and there really is not much to lose, so perhaps you will decide to stage an intervention for your brother-in-law. If so, I wish you good luck.

    Be well.











    Hello Dr. Robert,

    I was dating this guy for just four months starting back in March. We broke up the end of June after a fight in which he claimed that I never opened up to him and he also felt tense because he didn't know how I felt or what I was thinking. Funny, I thought we had been on the same page but apparently not. I know he was not cheating on me, as he always spent time with me when he wasn't working or going to school. We never exchanged "I love you's" but he obviously had strong feelings for me, and I for him. Well, I did try to "open up" by sending him a couple of letters after the breakup, but he never replied.

    Well, fast-forward to three weeks ago. I saw him at his place of work and asked if we could bury the hatchet and be friends. He agreed and the called me two days later. Then two days after that in which we spoke for two hours and he pretty much told me that he'd been upset because he felt that I only ever opened up to him as I would a friend. We were supposed to meet two days later but he got sick with the flu. I visited him five days later at work (it's a public place) but he was distant and when I asked him to give me a call later, he agreed but rolled his eyes. I told him to forget it, but then I called him three days later to find out what that was all about. He was very cold and said he had rolled his eyes because I was chatting with him for five or ten minutes in front of his boss (wasn't aware it was his boss) and that I lashed out at him (my "lashing out" was quietly commenting on the eye-rolling and telling him to never mind about calling me) He basically told me he'd given me three chances in the past (??!!) and that he didn't want to go there, back to the emotional roller-coaster ride and to just leave him alone.

    Well, this was almost 2 weeks ago, and I have left him alone. Unfortunately, he's taken up a lot of space, tremendous space in my mind, and I can't seem to stop thinking about him. I am mad at myself that I just didn't play it cool after he called and just waited for him to call me again, instead of going to see him like a love-sick child. Which I am not (I'm in my thirties) What can I do to help myself with this situation? I am tired of waking up with a knot in my stomach and feeling sad most of the time. How do I get over him and the urge to see or speak to him again??

    thanks ,

    Cherie



    Hello, Cherie, and thanks for your letter--

    "Dating" is a simple name for a very complex happening--the meeting of two egos--which often proves to be complicated and emotionally fraught. When people meet, the most primal wish of each of them is to be seen, heard, and understood. But often, when a couple begins to spend time together, and become involved sexually, their relationship, which ostensibly seems to be about sexual enjoyment and having fun together, often becomes burdened with all of the fears, anxieties, past disappointments, and other emotional vulnerabilities of both parties.

    In other words, "dating," which seems to be a process of "getting to know you," (and which would feel much more satisfactory if one really were being seen, heard, and understood) often is not really focused on getting to know, enjoy, and appreciate another person, but more on putting forth egotistical demands ("give me what I want and act as I want you to act") and on negotiating for the satisfaction of those demands.

    Sometimes this egoic negotiation goes on quietly, all but unnoticed beneath the surface, and other times it is blatant and obvious, but almost always it occurs on one level or another. For example, when a woman begins dating, her friends may give her advice on how to best manage the new relationship--such things as: "don't act too eager, be hard to get," or "don't let him have a certain kind of sex until he makes a certain kind of verbal commitment," etc. Clearly this is not essentially different from the advice that the CEO of a corporation gets from his advisors about negotiating a merger with another company, or that Dick Cheney gives to George Bush about how to deal with the Chinese.

    Now, I imagine that the fight you had was a part of this process of negotiation, a kind of demand by your boyfriend that you act differently. Unfortunately, I think it was a demand that you could not fulfill, even if you had understood it, and wanted to fulfill it. I think the demand was one that could not be fulfilled, because, although it seemed to be a demand that you be more forthcoming about your thoughts and emotions, I think that was a red-herring, and that your boyfriend's real demand was that you, a woman, become completely unthreatening to him, which is not possible. In other words, although you have not given me any information about the fight, I assume that your boyfriend must have been feeling frightened by some aspect of his involvement with you, and that his saying that he felt "tense" because he never knew what you were thinking was really a coded expression of that fear.

    To go a bit further with this, I imagine that his blaming you for "not opening up," was a form of projection of his own fear of opening up any further to you. When I say "projection," I am referring to the well-known psychological tendency among humans to deal with their own shadow material--the parts of themselves they dislike, fear, or about which they feel ashamed--by imagining that they see these things in another person, and then blaming the other person for being that way. For example, if a man is ashamed of his laziness and inability to get down to work, he might blame his girlfriend for being lazy and useless. This has the effect of taking the "bad stuff" out of himself, and putting it into another where he can condemn it without owning it. Projection, in other words, is a method of dealing with guilt, shame, and feelings of inferiority by scapegoating another person with them.

    If you understand this, you might agree with me that your boyfriend's blaming you for being unwilling to "open up," really may have indicated that he was unwilling to open up to you. I suspect this because if he really had been interested in knowing you and your thoughts more deeply, he could have approached that in a positive way by asking you questions about your inner world, or asking that you share more with him about your intimate life. In other words, the fight and the blame was his way of avoiding going any more deeply into an emotional involvement with you, and probably not at all an honest attempt to get you to open up to him. I should add that I also imagine that he is not conscious of any of this, and that, if he were asked about it, would have perfectly good reasons why you are not the woman for him.

    If this analysis is correct, probably there was nothing that you could have done or said that would have kept him wanting to continue in the relationship; he had "hit the wall," of his own emotional cage, and just could not go any further, regardless of what you said or did. Now you say that you regret that you just didn't play it cool after he called instead of rushing in to see him like a love-sick child. But as I have just explained, I really do not imagine that this breakup was a result of your having played the "dating game" (egoic manipulation, that is) badly, but rather a case of this man's being unable to go any further with you, and I hope that you will stop blaming yourself for a failure which probably was not yours.

    As for your present suffering, I am afraid that those blues are part of the price one pays for extending one's fleshly body and one's emotional body to another person and then ending up disappointed in the outcome. Everyone who has ever been through this kind of breakup will tell you that there is not much to do about the sense of rejection and loss except to wait for time to help heal the wound, to spend time with friends if possible, and to understand that it is better that this relationship--this particular egotistical negotiation, that is--has broken down now instead of a year from now, or five years from now, when you would have had so much more of yourself invested in the outcome. However, if after several weeks you do not at least begin to see some light at the end of the tunnel, please consult my article called "Am I Depressed?" for links to several on-line depression assessment tools, and recommendations about how depression should be treated.

    Be well.











    Dear Dr. Saltzman,

    You said that proper nutrition can help with physical, mental, and emotional steadiness, or physical, mental, and emotional stability. Does this mean that what I eat affects not just my physical health, but also my mental health? And if so, what should I eat?

    Hello,

    While the old saw that says, "you are what you eat" may be a bit exaggerated, the food, water, and other substances we consume can have profound effects on physical, mental, and emotional wellness (or the lack of wellness that, when it goes far enough, we call "illness").

    Everybody is different, and every body is different, so without a private consultation, I cannot give you person-specific advice about what you might like to add to your daily intake, and what you might like to subtract, but I will offer some general principles that can help almost anyone. If you do make changes in what you eat, drink, and otherwise consume, please bear in mind that you might have to stay with a change for several weeks before being able properly to evaluate the results.

    Evidence continues to mount up suggesting that the foods we eat have powerful psychological effects, so if you are not feeling calm and happy, and if you are feeling that something has to change, some dietary changes are a good place to begin.

    Here are some changes to try:

    1. In my view the most important change is to increase the quantity of fruits and vegetables in your diet. These foods, which really ought to be the basis of a healthy diet, not side dishes or garnishes, contain precious micronutrients such as flavonoids (plant pigments) that affect brain function, improve the efficiency of every cell in the body, and protect against heart troubles, cancer, and numerous other serious aliments. For example, the old adage that says, "an apple a day keeps the doctor away," turns out literally to be correct: quercetin, a powerful antioxidant especially abundant in apples (as well as in onions and black tea), immediately begins healing the entire human organism whenever it is present in the diet. To see what this means on a practical level, take a look at this. Other fruits and vegetables contain different micronutrients which are vitally important also for physical, mental, and emotional balance. A vitamin pill cannot supply these vital elements. Since the different colors of fruits and vegetables indicate different types of micronutrients, aim for a wide variety of color in your diet. If you choose your foods from this list of the world's healthiest foods, and learn how to store and prepare them here, you can't go wrong.

    2. Second, and also extremely important, is to replace as much as possible of the fats and oils in your diet with olive oil. There are many reasons to make this healthy change, but one reason is simple: the monounsaturated fats in olive oil "burn clean" in the body so that the arteries stay open and flexible. In fact, changing to olive oil can even reverse in some cases damage done by over consumption of the wrong fats. Those fats are "wrong" for the body because they do not burn clean, and consuming them on a regular basis gradually coats the arteries with sticky plaque, narrowing these blood vessels and thereby slowing circulation. Bill Clinton's recent quadruple bypass surgery demonstrated this for all to see; he was a junk food addict. Since good circulation is the very bedrock of health, there is little doubt that making this change can make a huge difference in how one feels.

    Further, recent research suggests that fresh extra-virgin olive oil contains a compound that helps fight inflammation in a way similar to such anti-inflammatory drugs as ibuprofen. Since the most up-to-date medical opinion holds that chronic low-grade inflammation and its accompanying rise in C-reactive protein levels seems to put otherwise healthy people at risk for such ailments as heart disease, arthritis, stroke, and many others, making olive oil the main source of fat in the diet--and this is the chief feature of the so-called "Mediterranean diet"--becomes even more advisable.

    To adopt this more conscious approach to eating means, for example, that you would use olive oil, not butter, lard, or any other vegetable oil, besides perhaps canola oil, to grease a skillet, to fry foods, etc. If you make tuna salad, for example, you would buy water pack tuna (to avoid consuming the low-grade vegetable oil that the canners use to pack tuna), and, instead of mayonnaise, you would use olive oil to prepare the salad. If you simply love the flavor of mayonnaise, use less, and make up the difference with olive oil. If you like bread and butter, try dipping the bread in a small bowl of olive oil flavored with herbs and garlic instead. Or, since avocado oil, while not quite as beneficial as olive oil, is also good, substitute avocado for most or all of the butter, and at least some of the cheese you are used to eating.

    This also means, I should point out, that you aim at sticking to low fat dairy items as much as possible (the olive oil you consume will provide the fat in much healthier form than butterfat), that you cut down on, or eliminate, fatty meats (replacing them with fish is a great idea). In other words, the aim is to replace questionable sources of fats and oils, with a substance, olive oil, which has known benefits.

    Particularly urgent is to avoid foods made with what are called "trans-fats." These are absolutely harmful to mind and body, and are used only so that packaged foods can stay "fresh" for years on the shelf. The label will usually indicate trans-fats as "partially hydrogenated," although that is not always true of Mexican products. It's worthwhile reading the labels of all packaged foods since many of them are filled with various poisons put there not for the health of the human body but for the convenience of the manufacturers.

    You don't have to allow the food manufacturers to dump this stuff into your personal ecosystem, your body. If you like microwave popcorn, for example, buy regular popcorn, not that poisonous concoction in the "microwave bag." Corn will pop just fine in an ordinary paper bag with a couple of small holes punched to allow steam to escape. Then you can flavor it with olive oil, garlic, grated cheese, etc.

    3. Add flax seed to your daily diet. This is sold widely in Mexico as linaza. Two or three tablespoons daily is a reasonable amount. Linaza is relatively inexpensive, tastes good--a kind of nutty flavor--and can be sprinkled on raw or cooked food with no problem. Studies have demonstrated antidepressant effects with regular use of flax seed. Also, the omega-3 fatty acids in flax are highly beneficial, being needed in the regulation
    of all biological functions.



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    I could go on, but this is sufficient information to begin experimenting with conscious attention to diet. If you try this out for a few weeks, I imagine you will feel increased energy, and a noticeably lighter mood.

    Drop another line, and let me know how it is going for you.

    Be well.











    Dear Dr. Robert--

    I was diagnosed with juvenile lupus around the age of 2. I remember some really horrible things including a kidney biopsy performed on me at the age of 2. I remember being put under for the surgery and more vivid are the physically painful memories waking up in the actual recovery room. I still remember vividly (like it was yesterday) the very moment I woke up . The scar I have even now looks like I had been filleted.

    I remember pushing my glass I.V. bottle up and down the halls. Out of a ward with 13 other juvenile lupus cases only 2 of us lived and the other boy was brain dead. My mom took me to an osteopath after the doctor called her one night at work and told her at best I had another 3 months to live and to bring me home and make the best of it.

    My mom physically fought my dad when she left with me for Arizona. All I remember about that trip was losing my first tooth, so many sick and dying people that Verna took care of, and going to her daughter's church where some man grabbed my head in both hands and prayed so loudly for me. My mom later told me that afterwards all I kept talking about were how very, very warm his hands were.

    We were supposed to be there for 2 weeks but I was so sick and I remember feeling so bad all the time that I wanted to go home after about 4 days and my mom said ok. When mom got me home I remember, actually I was becoming capable of remembering not being allowed any refined sugar having to drink an 8oz glass of carrot juice 3 times a week and an 8oz glass of beet juice once a week on top of taking 36 vitamin pills every morning with a glass of distilled water. The whole time my mom was weaning me off of lethal doses of prednisone, by herself without anyone else knowing what she was doing.

    Well I started to get better. Then the doctors threatened to take my parents to court to take me away from them for the good of medical science because the same doctors, who wrote me off as a botched science experiment, wanted to know what they did that made me begin to recover.

    Anyways there is a whole hell of a lot more to my story so pick an age and trust me an issue exists. And now I find that I have serious childhood issues that I feel are becoming debilitating in my 40's. In fact, your reply to the question about passive-aggressive personality described me to a T. I have noticed all of these features in my behavior:

    Procrastination

    Intentional inefficiency

    Chronic lateness, forgetfulness

    Sulking, pouting, withdrawing emotionally

    Avoiding responsibility by claiming forgetfulness

    Frequent complaining

    Fear of intimacy or emotional closeness

    Trying to control situations through emotional blackmail

    Making excuses and lying

    Feeling victimized

    Sending mixed messages so that one is never sure exactly what was said or what to expect

    Blaming others

    Resentment

    Sullenness

    Fear of authority

    Resistance to suggestions from others

    Unexpressed anger or hostility

    Making unfair demands on friends and associates


    It seems to get worse everyday and I feel that if I say anything about how I feel it will just be looked upon as another excuse for being lazy or not caring. Please, please help me. I'm a returning student suffering the same problems I had in grade school with horrendous grown-up consequences! To bring you up to speed on the most recent part of the story, my mom, the one that fought so hard to save my life, now refuses to have anything to do with me.

    I really hope to hear from you soon because this was a lot to dredge up just to be left twisting in the wind.

    Thank you,

    Bridgette



    Dear Bridgette--

    First, let me say that I am sorry for your suffering. You certainly have been through a lot, and I am not surprised to learn that you find yourself struggling with some worrisome behavioral and personality problems.

    Based upon the behavioral features you listed, your self-diagnosis of passive-aggressive personality seems correct, and, again, this comes as no surprise. Passive-aggressive personality is not, as I have stated in the article you mentioned, considered a mental illness or disease. Instead, passive-aggressive behavior is better seen as a survival mechanism which functioned more or less well in early life, but which now gets in the way of full adult functioning.

    Let me explain. Sadly, as a child, you were forced to endure a series of medical procedures which must have been painful, humiliating, and frightening. An adult would understand that these experiences were unavoidable due to your severe illness, but that does not make them any easier for a child to bear. After recovering to some extent, you were then forced to eat food which you did not want to eat, and to be deprived in many other ways of the personal freedom and sense of personal choice that would have been features of a more normal childhood, and which would have fostered the development of a more resilient ego.

    In other words, your daily experience included being forced to undergo all kinds of unpleasant experiences, and being deprived of any choice in the matter--a direct attack on your emerging sense of selfhood. How does one survive such an ordeal? Well, by passive resistance, by non-cooperation, by grudging consent, by obstinacy, by reluctance. Since you were too young and too weak simply to say no, to refuse, I imagine that you resisted all of these painful indignities as best you could: passively. That was the best you could do, and you did it. It was your survival mechanism--not the survival of the body, but of the ego, the survival, that is, of the sense of myself, my "I-ness," the survival of the person who has choices and options, the person who can say "yes" and say "no." In other words, the passive-aggressive style is simply one way of trying to maintain the integrity and strength of a fragile ego which has no better way of protecting its desire to choose for itself what to do and what not to do.

    Now, habits formed in early childhood tend to persist into adulthood, and this is what has happened in your life. Instead of learning simply to say "no" when you do not want to go along with the wishes of another person, you have persisted in using your childhood survival mechanism--passive resistance. In other words, you say "no" not directly, but by intentional inefficiency, or sulking, or sending mixed messages, or any of the other behaviors you mentioned having noticed in yourself.

    Unfortunately, what worked as a child, at least to some extent, does not work at all as an adult, and you find yourself with a personality--a way of expressing the ego, that is--which really cannot get the job done for you. Although you do not mean to, you put people off, even to the extent of having alienated your own mother. I say this with no sense of blame at all, Bridgette, but only to show you that I understand your situation, and that I empathize with you. Your conflicted personality style is not at all your fault--no one gets to choose his or her personality--but rather the result of your initial temperament at birth, modified by all of your life experiences. Unfortunately for you, many of those experiences, having been so difficult, have hurt you, left you dismayed, and have made your road as an adult difficult to travel.

    Now, having seen this, what can be done to help? In my experience, the passive-aggressive style of ego defense can develop into something much more useful, and much more joyful as well, by means of a psychotherapy which focuses on striking a balance between fulfilling the demands of the patient (which would tend to support and encourage the passive-aggressive style), and refusing those demands (which would feel like a rejection). Then, while trying to maintain this delicate balance between gratifying demands and frustrating them, the therapist would constantly, but gently, point out the probable consequences of the passive-aggressive behavior (unhappiness, loss of friendships, losing the confidence and trust of others, etc.). This may seem simple, and in a way it is, but, in my professional experience, it often works well, and, if you were my patient, that is how we would proceed.

    Now, Bridgette, you wrote that, "if I say anything about how I feel it will just be looked upon as another excuse for being lazy or not caring." But you do need to talk about how you feel. In fact, it is most urgent that you do so. However, you should not be talking about this to the people in your ordinary life who will not understand, and who will have no patience for your struggles. Instead, you ought to be talking to an experienced psychotherapist who will listen patiently, who will understand, and who will know how to help.

    In a word, Bridgette, I suggest that you get into therapy right away, and plan to continue for a year or two, at least, of once or twice weekly sessions until you feel that you can approach life more directly. As a returning student, I imagine that such therapy might be available to you on a no-cost or low-cost basis, and I wish you every success in this important work.

    Be well











    Dear Dr. Saltzman:

    A few months back, I experienced a notion regarding my therapist when he had initiated a hug at the end of a session rather spontaneously. I felt that there was perhaps something more therein (perhaps I was just overreacting).

    As time has passed, I've found myself having intense erotic feelings toward him, as well as a psychiatrist I occasionally see. I'm very much aware of the phenomena of erotic transference and countertransference and have experienced such before with teachers and professors. Though I've hinted at a few things before, these feelings have yet to be addressed in the psychotherapeutic setting.

    After just having had an extremely productive session in which I initiated a hug (for the first time in many months), I said I would be ready to open up and start talking more next time. I'm wondering how to address such feelings with the concerned parties? I don't want this to jeopardize our psychotherapeutic relationship in any way. Maybe I'm still living in a bit of a fantasy world and am stuck believing that these feelings I have toward my therapist and psychiatrist could come to fruition and therefore am more reluctant to mention such.

    I know I need to address this subject matter, but I don't know where to begin. Any suggestions would be much appreciated.

    Thank you very much for your time and consideration!

    Respectfully,

    Roxanne



    Dear Roxanne--

    Thank you for your question. In my view, it is usually wrong for a therapist to hug a patient (client) during the course of treatment. If there is to be a hug at all, I like to save the hug for the end of treatment. In this way, the hug becomes a hug to celebrate the new functional equality of the two people--now no longer doctor and patient, but two people who have finished a project together and who, most likely, will not meet again, or at least not meet under the intimate circumstances of the consulting room. Most importantly, since the hug is a goodbye hug, it is not a gesture which might complicate future work.

    Since I was not there to see and feel what happened, I cannot say anything specific about that particular hug, but the fact that it has troubled you so much at least suggests that it was not a good idea.

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    The drive toward sexual expression is powerful in all primates, including human beings. Erotic feelings naturally arise between people, no matter which social roles they may be occupying at the time, and therapists and patients certainly are not immune. In fact, as you pointed out, certain relationships (such as teacher/student, or therapist/patient) sometimes seem particularly marked by erotic feelings, and we call this "transference" because it is believed that at least part of the erotic fascination results from the transfer of feelings once directed towards early caregivers--mom or dad, for example--onto the teacher or therapist.

    But the feelings of a patient for his or her therapist are more than just transference. The process of exposing ones problems, fears, and hopes to another person who hears them with empathy may begin to feel a lot like a personal love relationship. True, since the patient does most of the exposing, while the therapist is the one to offer the empathic understanding, the relationship is a lot more one-sided than the typical romantic involvement. Nevertheless, feelings arise which are not just sexual, but also may feel, particularly to the patient but possibly also to the doctor, a lot like falling in love.

    Now one of the most important principles in effective psychotherapy is that the transference feelings must not be acted out, but seen, interpreted if necessary, and understood for what they are. It is the job of the doctor, not of the patient, to see that this principle is honored. This work does not always require that the transference feelings be discussed explicitly, but the work does demand that the therapist not gratify the patient's erotic and romantic feelings, but rather allow them to arise ungratified, and then to fall away again.

    Indeed, many, if not most, therapies involve, at least to some measure, the idealization of the therapist, and then the fading away of that idealization. In other words, the patient may begin to feel that the therapist is a kind of superman or superwoman, but as the therapy progresses, the idealization changes into the understanding that we are all just human beings, including the therapist.

    The therapist, for his or her part, has the obligation to accept the patient's idealizations (which may be erotic), but to give them back to the patient eventually. In other words, the therapist accepts the idealizations, but does not begin to feel that they really apply to oneself. After all, they are the patient's idealizations, and really apply more to the patient's inner family than they do to the therapist. If the therapist knows and remembers this, when the patient is ready to stop idealizing the therapist, the therapist will gladly stop being idealized. If the therapist forgets this and begins to act towards the patient as if the idealizations really were like what happens in a love affair, the therapist may not want to stop being idealized, and the therapy will be compromised. This is why that hug might not have been such a good idea. Humans, like gorillas, enjoy hugging and being hugged, but psychotherapy is not supposed to be about the therapist's enjoyment, nor even the patient's. Healing is the point, not enjoyment.

    Since feelings are beyond our control--they just come and go like the wind in the trees--the problem in any therapy cannot be with feelings in and of themselves--even with formidable erotic ones--but rather in how the therapist attends to them. I say in how the therapist attends to them because the client has no obligation whatsoever to use self-control in this matter. It is 100 percent up to the therapist to use care and discretion in this and in all the other delicate situations that arise in the intimacy and privacy of the consulting room. In this regard, the patient is like a child, and the therapist must be the adult. Many adults have erotic feelings towards children, but most would not think of acting on them. When an adult acts out sexually with a child, we do not blame the child, and the same is true of therapists regarding their patients. The patient is not to blame--ever--but the therapist is 100 percent wrong if he or she acts out sexually with a patient.

    In general, if a therapist becomes aware of strong erotic feelings toward a client--feelings which threaten to jeopardize the therapeutic relationship by sexualizing it--he or she is obligated ethically to find a way to deal with those feelings in a way which will neither compromise the therapy, nor injure the patient. The first recourse might be to ask the help of a colleague to whom one will confess the feelings and ask for help in understanding them. If that kind of help is not sufficient, and if the feelings are getting in the way of therapy, the therapist must refer the client to another professional for treatment.

    Now, you say that you felt an erotic overtone at the time of the hug, so I assume three possibilities:

    1. Your therapist had erotic feelings for you, and, when he hugged you, you felt them.

    2. You had erotic feelings for your therapist which you projected on to him when he hugged you. By "projection," I mean the phenomenon, known widely in psychology, in which a person imagines that his or her own feelings really belong to another person.

    3. Your erotic feelings were mutual.

    I am simplifying here, for there are other, more complex possibilities, but you get the idea.

    Now judging from what you have written, it seems clear that you have erotic feelings towards both of your caregivers. And, if your caregivers are any good at all, those feelings must not, and never will "come to fruition," as you said. There is nothing wrong with your fantasizing sex with either or both of those people. You certainly have a right to your desires and to your fantasies about them. But you should try to understand that your fantasies must remain fantasies if you are to benefit from--and not be hurt by--the treatment you are undergoing. Acting out sexually compromises the entire psychotherapeutic enterprise, and this is why it is unethical in the extreme.

    The way to address your sexual attraction towards your therapist and towards your psychiatrist is simple, or should be simple if your doctors are any good at all. You simply state that you have the feelings without trying to be delicate about it, and you let these trained professionals deal with it, just as they have to deal with all the other details of your inner life. You also have the right, if you wish, to ask your doctors if they have any such feelings towards you. If they have any trouble at all dealing with your confession or with any questions you may ask about their feelings towards you, in my opinion you should find new doctors right away.

    I hope this will help.

    Be well.







    Dear Dr. Saltzman,

    After reading about the symptoms of passive-aggressive disorder I realized that I matched every one of the criteria. I have been told that I have a need to please everyone and I have difficulty expressing anger in a healthy manner. I usually keep it bottled up and avoid dealing with the person I am angry with. I grew up with a physically and verbally abusive father. I remember thinking to myself at a young age during a period of frequent abuse that I had no other feelings for him except for fear. I truly wished at many points that he was dead so that I would not have to endure anymore of it. I could not even begin to defend myself; I was fearful of saying anything after he flew into one of his rages and often I didn't know what would set him off.

    He drank heavily off and on throughout my childhood. He would occasionally fly into irrational, violent rages after drinking and one particular period that stands out in my mind is finishing a scheduled after school sports activity with my sibling and not being able to remember whether he had said that we were to meet him by the front door or the back door of the mall which was a fairly good distance in between. My sibling and I raced back and forth to each entrance in a panic trying to look for him to come pick us up and finally after about half an hour passed and we began to realize that this may provoke him more, we just decided to walk on home, even though he had previously flown into rages for doing so because it was too dark to do so. He met us at the foot of the stairs at the front door and he had been taking heavy sedatives for chronic pain and had not discontinued his heavy use of alcohol. His features did not even resemble the father I knew. I never knew why he could look at us with so much hatred.

    Reflecting on this as an adult with a child of my own, I find this even more disturbing that one could harbor so much hatred to a ten year old child. We subsequently received excessive physical punishment. He would appear disgusted if we lay cowering on the ground as he was shoving us about, telling us to get up on our feet and quit acting like a baby. He used to box when he was younger and recalling this as an adult, it makes me think that he was dealing with his 10 year old daughter as a sparring partner.

    Although I obviously have mixed emotions toward my father today, the feelings I am most conflicted over are those of my feelings toward my mother who did little too prevent these incidents from my father. She would often justify his behavior by saying that we shouldn't have made him angry. When she was mad at us, she would threaten to tell my father about it, knowing fully well that doing so was likely to cause physical violence.

    I should back up and explain that what my mother has told me about her father was that he too was abusive both physically and mentally. She may say this in one conversation and then praise him in the next and downplay the abuse. In fact, in recent years, she has claimed to have totally not been at all present when the physical violence occurred!

    This total refusal to acknowledge these experiences which hurt and scared me so much has made me very angry. At this point, just for her to acknowledge that we were indeed exposed to physical and emotional abuse would be enough. Discounting that it ever existed or claiming that she was "out of the house" when it occurred makes my blood boil. During one period, I remember that at least some form of physical violence was occurring every two or three days. I even remember telling my dad to stop when he was hitting us at one point and telling him that he was a bully.

    But her whole take on the existence of this abuse varies with every conversation that we have about it. It makes me absolutely furious when she simply says that we are overreacting and downplays what has continued to affect me as an adult. I felt really letdown by my mother because she was supposed to be my protector. And as mentioned above, at times she would, as I remember telling her at one point, "sic" my dad on us. This comment was made as a child in reference to the way a master may send his dog to attack.

    In fact, she has conflicting stands on many issues and I know enough about psychology to know that this is because she too is a passive-aggressive personality, in that her coping skills involve appearing to hold no ill will toward those who anger her in one moment to bitterly complaining about them the next.

    In her relationship, with my father, she has been the victim of verbal but not physical abuse as far as I know. I remember thinking to myself at a young age that my mother would appear more like a child when she was dealing with my father when he became violent. It was a side of her I wasn't used to seeing. She constantly sends mixed feelings and contradictory stands on issues to me and my sibling constantly, to the point where I don't want to deal with her anymore and I feel very resentful and feel very little trust in her because she is so flaky. One moment she can be soft, kind, and helpful. The next moment, without any provocation, she is sullen, angry and appearing totally uncaring. I am worried that I will carry on with these behaviors. The comical relief that can be found in the situation is that she thinks that her children are the ones that are up and down! Perhaps we are, but she can't recognize that our behavior mirrors her own.

    Around the time that my the physical abuse increased (my dad went on unemployment for chronic pain and was home every day on his prescribed pain relief Demerol with little slowing down of his alcohol consumption, I began having problems. I realize this when I identified the year that he was laid off and the year that I began getting into trouble. I remember writing a swear word on a paint project at school to see what it looked like. Up until I began getting into trouble I was described as very polite and quite a daydreamer. I also had problems with stealing. Even from my own parents. Knowing that if I got caught I was likely to encounter some physical abuse. My self esteem was at a very low level. I was in grade four at this point, I was nine and ten years old and my self-esteem was horrible. I can realize the damage now that I have a child of my own.

    I picture what it would do to him if I were to call him, at nine years of age, names like F*ckin' bastard, Useless piece of crap, or a F*ckin' disgrace to the family and thrown from one side of the room to another. I still have a hard time realizing how this has affected me because at the same time this was being administered, I was told that I deserved it and my mom did nothing to stop it and would in fact threaten me with my father when she was dealing with me knowing that this behavior would ensue. And yet she constantly asks why I have problems with self esteem and why I am so hard on myself. I am tired of playing this stupid game.

    I became bulimic at fifteen. Both of my parents were highly controlling and domineering parents and I remember thinking that there was a relief in being able to control one thing myself that they could not do anything about and that was my eating. When I was seventeen and the overbearing controlling behavior would become unbearable, I began cutting myself with a razor blade at seventeen. I went on to suffer from problems with alcohol and drug abuse myself as did my sibling and I tolerated abusive behavior in my relationships. I should mention that my sibling also suffered from the same eating disorders, the same tendency towards cutting and the same abusive relationships. I began suffering from increased bouts of depression and panic attacks, when I was nineteen, I was subsequently treated for my anxiety disorder with anti-anxiety medication which my parents would discredit as everyday worries that could be treated without medicine.

    At twenty, I was the raped by a male acquaintance who drove me home after I had too much to drink. My parents first response was that it wouldn't have happened if I hadn't been drinking and made me feel like it was my fault. My boyfriend at the time had to explain to them the concept of date rape. What makes me furious is that my mother continues her denial by asking me (!) why we turned out the way that we did. Seeing the problems that we are now facing as the adults of an abusive alcoholic and a mother with passive-aggressive disorder is obviously too much to deal with and she has resorted to totally convincing herself that she has no idea how we turned out the way we did. She takes some sort of relief in the mistakes that we have made that are basically the result of a dysfunctional upbringing by focusing on these mistakes to deflect the focus off the accountability that she and my father need to be taking.

    Please suggest to me how I can begin to deal with this problem.



    Hello--

    Anger seems a normal and natural response to the obvious inequality of opportunity in this life--one child having supportive, sensitive, understanding parents, for example, while another has to suffer the kind of parenting that you experienced--but anger, while normal and natural, is only one stage, although an important one, in the process of coming to grips with one's actual situation. When I say "actual situation," I mean not the ideal situation that one wishes one had, but the factual, practical situation in which one finds oneself. In your case, as I understand what you have written, you find yourself an adult survivor of a violent and unfair upbringing who has to suffer with the inappropriate habits and outdated survival mechanisms which usually follow that kind of childhood conditioning.

    To put this another way, the anger you feel, while expected, and in many ways justifiable, needs to be chewed, swallowed, and digested, so that it can change from anger into understanding and compassion, particularly compassion for yourself and for the people who hurt you. Until this happens, you will be paying a double price for your frightening and damaging childhood. I say "double price" because as long as you continue to react to both the past and present actions and behaviors of your obviously inadequate and troubled parents by becoming "furious," as you put it, you will be hurting yourself in the present (a self-inflicted hurt which is what "fury" really is) in addition to the hurt you already sustained as the terrorized child of those troubled parents.

    You may think now that you would feel much better if your mother would only stop denying the "accountability that she and my father need to be taking," as you wrote, but in my experience this is rarely true. You will feel better, in my professional experience, when you accept the past for what it is, when you know in your heart that it is over and done, never to be changed and never to recur, and when with some psychotherapeutic help you find ways of living that work well for you now. As long as your feeling better depends upon what someone else (your mother) says and does, you have given away your power to that person. And, since you already know that your mother is confused and troubled, why would you want to let her have that power over you?

    To reclaim that power over your own life requires living for yourself as best you can, regardless of what some other person says or does. In other words, you are far too enmeshed with your mother, and your still waiting for apologies and statements of responsibility is one manifestation of that enmeshment (to see what I mean by "enmeshment," you might like to read this). When the enmeshment weakens, then you will feel freer to live in the present, and even to enjoy the present, and so then you will feel "better."

    To answer your precise question, I suggest that you seek regular sessions with an experienced psychotherapist in order to get help in moving beyond your anger and into the kind of deeper understanding which often follows just after anger, and which, once grasped, can make surprising and positive changes both in point of view and in personal behavior. In my experience, a therapeutic approach called "cognitive-behavioral" often works particularly well in helping people to achieve the attitude needed for this kind of "getting on with it, so you might like to look for someone with training in cognitive-behavioral psychotherapy.

    Be well.











    Hello there!

    I just love your website. Love it!

    Anyway, I am writing you because I have a question. I am a very happy guy. I'm in a relationship with a great guy. We have been together for a month now and I am convinced I have fallen in love with him. Last night however we were discussing some things. He brought up a problem I have been having with something he has been doing. You see, he makes comments on other men in front of me and others. He finds there no problem with saying "Oh, that's guy's hot" in front of me. I told him that I think that is disrespectful to me and embarrassing to me when we are in the presence of others. I feel as though it degrades me for him to be commenting on the attractiveness of other men. I was just wanting your opinion of this.

    There is also something else I wanted to ask you. My partner feels as though it is not only permissible but natural to invite a third into our bedroom. This completely disgusts me. Despite all my trying I cannot force myself to accept this. It is hard for me to understand why he believes it is okay to have another person sharing something I perceive to be reserved for those in a relationship. I try to explain to him all the levels that I cannot even begin to think about doing it. My belief in complete monogamy, religion, social factors, just everything I know of says that this is completely wrong. He tries to tell me that this is natural, and is something that will strengthen our relationship. I cannot ever see that.

    He is a smart man. He is an MD, a pediatrician. What can I do or say to strengthen my side of the argument? So two questions. How can I confront him with both of these issues. 1. Talking about other men in front of me. 2. The idea of bringing an outsider into bed. HELP!

    Thank you so very much,

    James



    Dear James--

    I am glad you enjoy my website, and thanks for your kind comments.

    Your letter points to a kind of relationship which, unfortunately, is quite common: one finds oneself attracted to another person, but then one is made unhappy by certain behaviors of that person, and one wants the behaviors to change. In other words, this "great guy," whom you feel you love, also has some habits which, to you, are not at all lovable, and you wish he would change. In fact, you are trying to use all your powers of persuasion to convince him to change, because you believe that he would be the perfect match for you if only he would stop commenting on the looks of other men, and stop asking to bring them into your bedroom for shared sex.

    The problem is, James, that these behaviors, which you find disgusting and repellant, are as much a part of your friend as are the things about him that you find compelling and attractive. Now in my experience, people do not change their behaviors because others want them to do so, but only if they themselves find potent reasons for changing. As I see it, this leaves you with only two viable alternatives: either learn to live with the sexual predilections of your new boyfriend, or else admit to yourself that although he is a pretty cool guy in many ways, his sexuality is too raunchy for your tastes, and move on.

    I am sorry to be so blunt, but I have been privy to countless relationships of this kind, and unless there is a long shared history along with other important reasons for being together (important reasons beyond mere attraction, that is), it is almost always better--as difficult as this may seem when you are "in love"--to move on, and to keep looking for someone whose entire way of being works for you. But, naturally, that is a choice that only you can make.

    Be well.








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    last update: February 20, 2011